Mohamed Haflah Nor Hazla, Chan Ke Jing Patrina, Kesu Belani Levin, Sani Mohamed H, Mat Saad Arman Zaharil, Wan Ismail Faisham
Orthopaedics, Faculty of Medicine, Unversiti Kebangsaan Malaysia, Kuala Lumpur, MYS.
Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS.
Cureus. 2024 Sep 16;16(9):e69547. doi: 10.7759/cureus.69547. eCollection 2024 Sep.
A vascularized fibula flap is an option to reconstruct osseous and soft tissue defects involving distal radius malignancy with massive soft tissue involvement. This reconstruction method is a strong anatomical construct for wrist arthrodesis and flexible septocutaneous tissue for closure. However, in rare cases of bilateral peroneal magna artery, a vascularized fibula flap is not a suitable option given its potential risk of limb ischemia. We report the case of a 35-year-old lady with recurrent distal radius giant cell tumor with bilateral peroneal magna artery, whereby a vascularized fibula flap is not a reconstruction option for the distal radius. In this case, we opted to use the deep circumflex iliac artery (DCIA) flap to reconstruct the defect. This case highlights the importance of clinical assessment and Doppler evaluation before harvesting a vascularized fibula graft and the DCIA flap as an alternative option for reconstruction of the distal radius with a good functional outcome eight years post-operation.
带血管蒂腓骨瓣是一种用于重建涉及桡骨远端恶性肿瘤且伴有大量软组织受累的骨与软组织缺损的选择。这种重建方法对于腕关节融合是一种强大的解剖结构构建,并且提供了用于闭合的灵活的皮下组织。然而,在罕见的双侧腓总动脉存在的情况下,带血管蒂腓骨瓣因其潜在的肢体缺血风险而不是一个合适的选择。我们报告了一例35岁女性复发性桡骨远端巨细胞瘤且伴有双侧腓总动脉的病例,在此病例中,带血管蒂腓骨瓣不是桡骨远端的重建选择。在该病例中,我们选择使用旋髂深动脉(DCIA)瓣来重建缺损。该病例强调了在获取带血管蒂腓骨移植物之前进行临床评估和多普勒评估的重要性,以及DCIA瓣作为桡骨远端重建的替代选择在术后八年具有良好功能结果的情况。