title: Assessment of donor-site morbidity using balance and gait tests after bilateral fibula osteoseptocutaneous free flap transfer.
abstract: The donor-site morbidity from harvesting unilateral free fibular osteoseptocutaneous flaps has been previously evaluated and is considered minimal. The purpose of this study was to investigate functional deficits after bilateral fibular osteoseptocutaneous flap harvest. Between 1990 and 2004, 7 consecutive patients undergoing mandible reconstruction utilizing bilateral autogenous free fibular osteoseptocutaneous flaps were included in the study. They were evaluated for the following subjective symptoms on the donor leg: pain, paresthesia, walking ability, restriction in activity, gait alteration, and aesthetic result. In addition, balance test and gait analysis were used to quantitatively assess functional outcomes. The results of this objective assessment were compared with those of 8 age-matched control subjects. Most patients had few subjective symptoms. The most common complaints were pain after prolonged walking (14%), slight difficulty in squatting (28%), and minimal paresthesia on 1 of the donor legs (14%). There were no significant differences in reaction time and movement velocity on either the balance test or gait analysis between the study and control groups (P > 0.05). However, there were significant differences with regard to right backward directional control, maximum stability with eye closing, sway referenced support, and ankle strategy (P < 0.05). Long-term follow-up revealed minimal donor-site morbidity after bilateral fibular osteoseptocutaneous free flap harvests. The functional deficits could only be found under the most unfavorable sensory feedback conditions.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Medical College, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Jeng-Yee
authors.initials: JY
authors.lastname: Lin
authors.forename: Risal
authors.initials: R
authors.lastname: Djohan
authors.forename: Michael
authors.initials: M
authors.lastname: Dobryansky
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Chou
authors.forename: Wen-Hsuan
authors.initials: WH
authors.lastname: Hou
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Chen
authors.forename: Fu-Chan
authors.initials: FC
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D019937:Diagnostic Techniques and Procedures; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D004856:Postural Balance / Q000502:physiology*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps