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European Journal of Orthopaedic Surgery & Traumatology

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27.01.2022 | General Review

Outcomes of free vascularised fibular graft reconstruction in upper limb trauma—a systematic review

verfasst von: Frank Liaw, Say How Teoh, Isabella Stevens-Harris, Wareth Maamoun

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 2/2023

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Abstract

Purpose

To evaluate existing literature describing the use of free fibular flaps in upper extremity trauma and summarise flap outcomes. Secondary objectives are to evaluate patient demographics and flap characteristics.

Methods

EMBASE, PubMed, MEDLINE and the Cochrane Database were searched for eligible studies published from 1975 to January 2019. Primary outcome measures collected were rate of union, graft survival rate, and complication rates. Patient demographics and flap characteristics were also collected. Statistical analysis was performed using SPSS software (SPSS version 25; IBM, Chicago, USA). Pooled data were presented as mean and standard deviation or median and range. Categorical variables were assessed by chi-squared test. Quality of studies were assessed using the National Institutes of Health (NIH) Quality Assessment Tool for case series studies.

Results

Initial search yielded 1070 articles. A total of 25 studies (151 cases) met the inclusion criteria. Flap survival was 97% (147/151) at time of follow-up, with first union rate of 95% (142/151) and second union rate of 97% (147/151) following bone graft or further procedure. Overall complication rate was 33% (47/140). There was a statistically significant association between recipient flap site and rates of flap fracture (p = 0.049). There was no statistically significant association between flap type, evidence of infection at donor or defect site, or method of flap fixation on outcomes.

Conclusions

Vascularised fibular flaps are a safe and efficacious reconstructive option for upper limb trauma. Further research is required to enable better understanding of the impact of patient and clinical factors on flap outcome measures.

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Titel: Outcomes of free vascularised fibular graft reconstruction in upper limb trauma—a systematic review
verfasst von: Frank Liaw
Say How Teoh
Isabella Stevens-Harris
Wareth Maamoun
Publikationsdatum: 27.01.2022
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 2/2023
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-021-03185-9

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Outcomes of free vascularised fibular graft reconstruction in upper limb trauma—a systematic review