Results of Cross-leg Free Vascularized Fibular Graft

NCT ID: NCT06491316

Last Updated: 2024-07-09

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 22 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2024-07-20
• Study Completion Date: 2024-10-30

Brief Summary

This study aims to evaluate the new technique of cross-leg vascularized fibular graft for reconstruction of post-traumatic long tibial bone defects in terms of restoring normal anatomy and function of the traumatized limb in a series of cases admitted in Assiut University hospital, Orthopedics and trauma surgery department.

Detailed Description

Reconstruction of post-traumatic long tibial bone defects is still a major therapeutic challenge faced by orthopaedic surgeons on both anatomical and functional concerns, and it is usually associated with significant long-term morbidity. Historically, Amputation was the treatment of choice for long tibial bone defects because of difficulty of reconstructove management of such cases. Over the last few decades, Limb salvage procedures have been developed. During the second world war, massive cancellous bone autograft has been the preferred treatment. But traditional bone graft procedures in many cases may be limited by uncontrollable graft resorption. To overcome this disadvantage different management options have been developed to address bone defects of various lengths as vascularized fibular grafts, Ilizarov technique using bifocal or trifocal bone transport, acute limb shortening and masquelet procedure. However, In some cases long bone defects are associated with extensive soft tissue lacerations together with poor ipsilateral blood supply. For those cases previous surgical options are associated with many complications and may end up with failure of reconstruction and amputation, in this situation cross-leg vascularized fibular graft may be a good treatment option because it can provide a blood supply away from that of the extensively traumatized limb.

Conditions

Tibial Fractures

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: RETROSPECTIVE

Eligibility Criteria

Inclusion Criteria

• Patients who were admitted into Assiut University Hospital, Orthopedics and Trauma Surgery department with big tibial bone defects ranging from 12 cm to 26 cm, associated with extensive soft tissue damage and poor ipsilateral blood supply confirmed by CT angiography and treated with cross-leg free vascularized fibular graft.

Exclusion Criteria

• Patients with bilateral extensive soft tissue damage and poor blood supply.
• Patients with medical conditions preventing them from general anesthesia for long periods (>10 hours).

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

Mahmoud Mohammad Saad

Demonstrator at Orthopedics and Trauma surgery department, Assiut university hospital

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Assiut University Hospital

Asyut, , Egypt

Countries

Egypt

Central Contacts

Mahmoud M Saad, MBBCh

Role: CONTACT

Mahmoud.20134331@med.aun.edu.eg

00201060039941 ext. 0020882340431

Omar A Refai, Lecturer

Role: CONTACT

omarrefai@aun.edu.eg

00201003412298

Facility Contacts

Amr E Ali, Professor

Role: primary

Amr.elsayed@med.aun.edu.eg

00201099021770

References

Watson JT, Anders M, Moed BR. Management strategies for bone loss in tibial shaft fractures. Clin Orthop Relat Res. 1995 Jun;(315):138-52.

Reference Type: BACKGROUND

PMID: 7634662 (View on PubMed)

Weinberg H, Roth VG, Robin GC, Floman Y. Early fibular bypass procedures (tibiofibular synostosis) for massive bone loss in war injuries. J Trauma. 1979 Mar;19(3):177-81. doi: 10.1097/00005373-197903000-00008.

Reference Type: BACKGROUND

PMID: 458883 (View on PubMed)

Wu Y, Yin Q, Rui Y, Sun Z, Gu S. Ilizarov technique: Bone transport versus bone shortening-lengthening for tibial bone and soft-tissue defects. J Orthop Sci. 2018 Mar;23(2):341-345. doi: 10.1016/j.jos.2017.12.002. Epub 2017 Dec 28.

Reference Type: BACKGROUND

PMID: 29290472 (View on PubMed)

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Reference Type: BACKGROUND

PMID: 7927661 (View on PubMed)

Tong K, Zhong Z, Peng Y, Lin C, Cao S, Yang Y, Wang G. Masquelet technique versus Ilizarov bone transport for reconstruction of lower extremity bone defects following posttraumatic osteomyelitis. Injury. 2017 Jul;48(7):1616-1622. doi: 10.1016/j.injury.2017.03.042. Epub 2017 Apr 4.

Reference Type: BACKGROUND

PMID: 28408083 (View on PubMed)

Catagni MA, Azzam W, Guerreschi F, Lovisetti L, Poli P, Khan MS, Di Giacomo LM. Trifocal versus bifocal bone transport in treatment of long segmental tibial bone defects. Bone Joint J. 2019 Feb;101-B(2):162-169. doi: 10.1302/0301-620X.101B2.BJJ-2018-0340.R2.

Reference Type: BACKGROUND

PMID: 30700126 (View on PubMed)

Zhang Y, Wang Y, Di J, Peng A. Double-level bone transport for large post-traumatic tibial bone defects: a single centre experience of sixteen cases. Int Orthop. 2018 May;42(5):1157-1164. doi: 10.1007/s00264-017-3684-y. Epub 2017 Nov 11.

Reference Type: BACKGROUND

PMID: 29129017 (View on PubMed)

Other Identifiers

Results of Cross-leg FVFG

Identifier Type: -

Identifier Source: org_study_id