Smith Joshua D, Sridharan Shaum S, Contrera Kevin J, Richmon Jeremy D, Feng Allen L, Chinn Steven B, Heft-Neal Molly E, Spector Matthew E
Department of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
Department of Otolaryngology - Head & Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Oral Oncol. 2024 May;152:106757. doi: 10.1016/j.oraloncology.2024.106757. Epub 2024 Mar 22.
Osseous and osteocutaneous fibular free flaps are the workhorse of maxillomandibular reconstruction over 30 years after the initial description. Since 2019, we have routinely used the Spider Limb Positioner, adapted from its use in shoulder orthopedic procedures, for fibular free flap harvest. Herein, we describe this novel technique in our cohort.
We describe our intraoperative setup and endorse the versatility and utility of this technique in comparison to other reported fibular free flap harvest techniques.
The Spider Limb Positioner was used 61 times in 60 different patients to harvest osseous or osteocutaneous fibular free flaps. Median (range) tourniquet time for flap harvest was 90 (40-124) minutes. No iatrogenic nerve compression injuries or complications related to lower extremity positioning occurred.
We describe a novel approach to fibular free flap harvest utilizing the Spider Limb Positioner, which affords optimal ergonomics, visibility, and patient repositioning. There were no nerve injuries or complications related to positioning in our series.
自首次描述以来的30多年里，带骨和带骨皮的腓骨游离皮瓣一直是上颌下颌骨重建的主要手段。自2019年以来，我们常规使用从肩部骨科手术中借鉴而来的蜘蛛肢体定位器来获取腓骨游离皮瓣。在此，我们在我们的队列中描述这种新技术。
我们描述了我们的术中设置，并认可该技术与其他已报道的腓骨游离皮瓣获取技术相比的多功能性和实用性。
蜘蛛肢体定位器在60例不同患者中使用了61次，以获取带骨或带骨皮的腓骨游离皮瓣。获取皮瓣的中位（范围）止血带时间为90（40 - 124）分钟。未发生医源性神经压迫损伤或与下肢定位相关的并发症。
我们描述了一种利用蜘蛛肢体定位器获取腓骨游离皮瓣的新方法，该方法提供了最佳的人体工程学、视野和患者重新定位。在我们的系列中没有神经损伤或与定位相关的并发症。
