Department of Maxillofacial Surgery, University Medical Centre Schleswig-Holstein, Germany.
Department of Maxillofacial Surgery, University Medical Centre Schleswig-Holstein, Germany.
J Craniomaxillofac Surg. 2018 Nov;46(11):1939-1942. doi: 10.1016/j.jcms.2018.09.003. Epub 2018 Sep 19.
The fibula flap has been established for orofacial reconstruction following ablative surgery. Donor-site morbidity of the lower leg may be explained by the harvest technique and particularly by detachment of the M. extensor halluces longus (EHL) and M. extensor digitorum longus (EDL).
On cadaveric lower leg specimens, the tendons of the EHL and EDL were dissected at the proximal phalanges and loaded with corresponding weights. The average displacement of the muscle was evaluated during the harvesting procedure.
Cumulative detachment of the interosseous membrane caused considerable displacement of the EHL but less impairment of the EDL. Segmental and cumulative osteotomy of the fibula implicated significant displacement of both EHL and EDL.
A recommendation can be given for cautious selection of osteotomy site of the fibula and for limited sacrifice of the fibula and adjacent attachments of the extensors to keep local-site morbidity at a minimum.
游离腓骨瓣已被确立用于口腔颌面缺损的重建。小腿供区的并发症可能与取材技术有关，特别是与伸肌支持带（EHL）和趾长伸肌（EDL）的分离有关。
在尸体小腿标本上，在近节趾骨处解剖 EHL 和 EDL 的肌腱，并加载相应的重量。在取材过程中评估肌肉的平均移位。
骨间膜的累积分离导致 EHL 明显移位，但 EDL 受损较小。腓骨的节段性和累积性截骨导致 EHL 和 EDL 均有明显移位。
建议谨慎选择腓骨的截骨部位，并尽量减少腓骨和邻近伸肌附着点的牺牲，以将局部并发症降至最低。
