title: Effect of fibula free flap harvest on the gait of head and neck cancer patients: preliminary results.
abstract: OBJECTIVE
  To determine the impact of fibula free flaps (FFFs) on gait.
  
  
  METHODS
  Prospective trial.
  
  
  METHODS
  FFF patients who gave consent were enrolled.
  
  
  METHODS
  At preoperative and 3-month postoperative visits, patients walked 30 m with the Walkabout Portable Gait Monitor (WPGM), a portable device developed at Dalhousie University that records acceleration of the centre of mass. Gaitview software provided several outputs for analysis: vertical (VA) and forward (FA) asymmetry, horizontal to vertical power ratio (HVP), vertical to forward power ratio (VFP), velocity, and step length. Patients were compared pre- and postoperatively and to age-matched control data with a Student paired t-test. Patients completed a self-comorbidity questionnaire and a point evaluation system (PES) with subjective questions on gait. PES data were compared to a Mann-Whitney U test using SPSS, version 15.0.1.
  
  
  METHODS
  Gaitview output and PES questionnaire.
  
  
  RESULTS
  From September 2008 to January 2010, 12 patients enrolled in the study. Eight provided 3-month postoperative data. The Gaitview analysis showed that none of the six parameters changed postoperatively. The VA and FA preoperatively and at 3 months postoperatively were 21.3 versus 24.2, p > .50, and 65.4 versus 74.9, p > .50, respectively. The HVP and VFP preoperatively and postoperatively were 133.4 versus 138.9, p > .50, and 129.6 versus 122.8, p > .50, respectively. The velocity and step length preoperatively and postoperatively were 125.9 versus 119.5 cm/s, p > .50, and 76.0 versus 74.9 cm, p > .50, respectively. The subjective PES questionnaire did not change significantly (p  =  .26).
  
  
  CONCLUSIONS
  Preliminary findings confirm that the FFF is associated with little subjective or objective gait impairment.
authors: Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, NS.
authors: Kristian I
authors: KI
authors: Macdonald
authors: S
authors: S
authors: Mark Taylor
authors: Jonathan R B
authors: JR
authors: Trites
authors: Elaine W
authors: EW
authors: Fung
authors: Phillip G
authors: PG
authors: Barnsley
authors: Michael J
authors: MJ
authors: Dunbar
authors: J
authors: J
authors: Lorne Leahey
authors: Robert D
authors: RD
authors: Hart
mesh_terms: D000368:Aged; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D020858:Tissue and Organ Harvesting / Q000379:methods*