Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
JBJS Case Connect. 2024 Aug 8;14(3). doi: e24.00092. eCollection 2024 Jul 1.
A 51-year-old woman, who had previously undergone C5-C7 anterior cervical discectomy and fusion, presented with symptomatic hardware failure and subsequently underwent instrumentation removal. Her postoperative course was complicated by an esophageal perforation. Despite initial repair using a rotational flap, the leak persisted, prompting esophageal reconstruction with a radial forearm free flap (RFFF).
Persistent esophageal perforation is exceedingly rare and difficult to treat. This report discusses the surgical technique for RFFF, an excellent option for revising failed sternocleidomastoid rotational flaps. The decision between rotational repair and free flap reconstruction depends on factors such as defect size, vascularization, wound condition, and donor site morbidity.
一名 51 岁女性，曾行 C5-C7 前路颈椎间盘切除融合术，因有症状的内固定失败而就诊，随后行内固定取出术。术后并发食管穿孔。尽管最初采用旋转皮瓣进行了修复，但瘘口仍持续存在，因此采用游离桡动脉皮瓣（RFFF）进行了食管重建。
持续性食管穿孔极为罕见且难以治疗。本报告讨论了游离桡动脉皮瓣（RFFF）的手术技术，这是修复失败的胸锁乳突肌旋转皮瓣的极佳选择。旋转修复与游离皮瓣重建之间的决策取决于缺损大小、血供、伤口状况和供区并发症等因素。
