title: Osteocutaneous radial forearm free flaps: prophylactic fixation of donor site using locking plate augmented with mineral cement.
abstract: Prophylactic plating of donor site in osteocutaneous radial forearm free flaps have demonstrated improvement in fracture rates. Previous series used conventional plating systems which rely on plate-bone friction forces to generate stability and can result in iatrogenic fractures if not accurately contoured. Locking plates have superior stability and do not require contouring. This retrospective series reports our experience using locking plate fixation augmented with calcium phosphate mineral cement. Twenty patients' records were reviewed; 13 were alive and reviewed clinically. Mean radiological follow-up was 28.2 months. Two deceased patients had donor site fractures diagnosed on the first postoperative radiograph. These fractures were related to technical fixation errors and failure to apply correct locking fixation principles. None of the other patients with proper locking fixation had fractures or metalwork related complications. We believe that locking fixation augmented with mineral cement can provide more biological stability and enhance restoration of bone structural strength.
authors.affiliation: Orthopaedic Department, Sunderland Royal Hospital Sunderland, SR4 7TP, UK. firasyaish2@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Ya'ish
authors.forename: A
authors.initials: A
authors.lastname: Waton
authors.forename: H
authors.initials: H
authors.lastname: B'Durga
authors.forename: A
authors.initials: A
authors.lastname: Nanu
mesh_terms: D000368:Aged; D001843:Bone Cements; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005542:Forearm / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D008297:Male; D011885:Radius Fractures / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D013536:Suture Techniques / Q000295:instrumentation*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*
chemical_list: D001843:Bone Cements