Principles of Microvascular Surgery.
Principles of Microvascular Surgery.
Principles of Microvascular Surgery.
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Free flaps - osseous / osseocutaneous<br />
• First transfer - Ostrup & Friedrickson, PRS 1974 -<br />
• Buncke, PRS 1977 - free rib osseocutaneous flap<br />
to lower leg for tibial pseudoarthrosis.<br />
• Serafin, Br J Plast Surg 1977 - rib<br />
osseocutaneous flap for mandibular<br />
reconstruction.<br />
• Taylor, 1979 - first to report the free fibula flap.<br />
• Taylor, PRS 1978 - free iliac crest flap.<br />
Free flaps - osseous / osseocutaneous<br />
• The free fibula flap -<br />
» Peroneal vessels a+v.<br />
» Up to 26cm <strong>of</strong> vascularized cortical bone.<br />
» Blood supply - endosteal + musculoperiosteal.<br />
» Good for reconstruction <strong>of</strong> - femor, tibia, humerus,<br />
radius and ulna that are not amenable to grafting by<br />
conventional nonvascularized bone graft.<br />
» Mandibular reconstruction.<br />
» Cortical bone - stress and weight bearing.<br />
» The epiphysis <strong>of</strong> the fibular head supplied by branches<br />
<strong>of</strong> the tibial artery.<br />
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