Kuzanov Ketevan, Bremberg Emma K, Soram Malemnganbi, Kuzanov Aleksandre, Kuzanov Ivane
Medicine, Riga Stradins University, Riga, LVA.
Plastic and Reconstructive Surgery, Kuzanov Clinic, Tbilisi, GEO.
Cureus. 2025 Apr 10;17(4):e82000. doi: 10.7759/cureus.82000. eCollection 2025 Apr.
The vascularized fibula flap is often utilized in various reconstructive surgeries to cover a bone or soft tissue defect due to its generous length, adequate vascularization, and the possibility of removal with minimal loss of limb function. We present a 32-year-old male patient with a 27-cm femoral diaphysis defect caused by a high-impact car accident, which led to multiple femoral fractures and was further complicated by osteomyelitis. Initial consultations with other physicians advised limb amputation as the sole approach due to the severity of the case and potential complications. Upon presentation at Kuzanov Clinic, the possibility of salvaging the limb using the vascularized fibula flap was proposed. A 27-cm fibula flap was harvested and transplanted to the femoral defect. Anastomosis was established between the vasculature of the flap and the recipient zone. A few months after the surgery, an upper fibular fracture occurred, which later healed, and the fibula hypertrophied. At a 10-year follow-up, the patient remains ambulatory, with limb shortening effectively managed with a custom shoe.
带血管蒂腓骨瓣因其长度足够、血供充足且切除后对肢体功能影响最小，常被用于各种重建手术中以覆盖骨或软组织缺损。我们报告一名32岁男性患者，因高冲击力车祸导致股骨干27厘米缺损，引发多处股骨骨折，并伴有骨髓炎。由于病情严重及潜在并发症，最初咨询其他医生时建议截肢作为唯一治疗方法。患者到库扎诺夫诊所就诊时，提出了使用带血管蒂腓骨瓣挽救肢体的可能性。切取了一段27厘米的腓骨瓣并移植到股骨缺损处。在瓣的血管与受区之间建立了吻合。术后几个月，腓骨上段发生骨折，随后愈合，腓骨出现肥大。在10年随访时，患者仍可行走，通过定制鞋有效解决了肢体短缩问题。
