Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional Outcome
The autologous vascularised free fibula flap is currently considered the best option for facial reconstruction after oncological surgery, but its donor-site morbidity has not been fully examined. The purpose was to evaluate donor-site changes in temporal and spatial kinematic gait parameters during...
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| Format: | Article |
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MDPI AG
2022-09-01
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| Online Access: | https://www.mdpi.com/2073-8994/14/9/1888 |
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| author | Matteo Zago Riccardo Di Giuli Giada Beltramini Alessandro Bolzoni Alessandro Baj Manuela Galli Aldo Bruno Giannì Chiarella Sforza |
| author_facet | Matteo Zago Riccardo Di Giuli Giada Beltramini Alessandro Bolzoni Alessandro Baj Manuela Galli Aldo Bruno Giannì Chiarella Sforza |
| author_sort | Matteo Zago |
| collection | DOAJ |
| description | The autologous vascularised free fibula flap is currently considered the best option for facial reconstruction after oncological surgery, but its donor-site morbidity has not been fully examined. The purpose was to evaluate donor-site changes in temporal and spatial kinematic gait parameters during stair climbing, as well as the gait symmetry. Fourteen patients (48 ± 16 years) were evaluated before and six months after harvest of a vascularised free fibula flap. Temporal gait variables for both the ascent and descent phases did not change after surgery (2-way ANOVA, <i>p</i> > 0.05). During stair ascent, ankle flexion (healthy side, increased; donor side, reduced; low effect size) had a significant time × side interaction. During stair descent, hip flexion was significantly larger on the donor side (medium effect size). Significant time × side interactions were observed for ankle inversion (healthy side, reduced; donor side, increased; and low effect size) and knee flexion (healthy side, increased; donor side, unchanged; and low effect size). Medium effect sizes were found for hip flexion side differences (significant). No relevant spatio-temporal nor kinematic asymmetry emerged apart from ankle joint kinematics. Overall, only the side effect of hip flexion during descent was both statistically significant and practically meaningful. Considering the slight modifications of the gait variables, no major functional limitations were found following vascularised free fibula flap reconstruction during stair climbing and descent. |
| first_indexed | 2024-03-09T22:22:21Z |
| format | Article |
| id | doaj.art-9318158ce22f457b9dcddb75f76a7430 |
| institution | Directory Open Access Journal |
| issn | 2073-8994 |
| language | English |
| last_indexed | 2024-03-09T22:22:21Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Symmetry |
| spelling | doaj.art-9318158ce22f457b9dcddb75f76a74302023-11-23T19:12:38ZengMDPI AGSymmetry2073-89942022-09-01149188810.3390/sym14091888Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional OutcomeMatteo Zago0Riccardo Di Giuli1Giada Beltramini2Alessandro Bolzoni3Alessandro Baj4Manuela Galli5Aldo Bruno Giannì6Chiarella Sforza7Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, I-20133 Milano, ItalyDipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, I-20133 Milano, ItalyDepartment of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, I-20133 Milano, ItalyDepartment of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, I-20133 Milano, ItalyDepartment of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, I-20133 Milano, ItalyDipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, I-20133 Milano, ItalyDepartment of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, I-20133 Milano, ItalyDipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, I-20133 Milano, ItalyThe autologous vascularised free fibula flap is currently considered the best option for facial reconstruction after oncological surgery, but its donor-site morbidity has not been fully examined. The purpose was to evaluate donor-site changes in temporal and spatial kinematic gait parameters during stair climbing, as well as the gait symmetry. Fourteen patients (48 ± 16 years) were evaluated before and six months after harvest of a vascularised free fibula flap. Temporal gait variables for both the ascent and descent phases did not change after surgery (2-way ANOVA, <i>p</i> > 0.05). During stair ascent, ankle flexion (healthy side, increased; donor side, reduced; low effect size) had a significant time × side interaction. During stair descent, hip flexion was significantly larger on the donor side (medium effect size). Significant time × side interactions were observed for ankle inversion (healthy side, reduced; donor side, increased; and low effect size) and knee flexion (healthy side, increased; donor side, unchanged; and low effect size). Medium effect sizes were found for hip flexion side differences (significant). No relevant spatio-temporal nor kinematic asymmetry emerged apart from ankle joint kinematics. Overall, only the side effect of hip flexion during descent was both statistically significant and practically meaningful. Considering the slight modifications of the gait variables, no major functional limitations were found following vascularised free fibula flap reconstruction during stair climbing and descent.https://www.mdpi.com/2073-8994/14/9/1888free fibular flapmorbiditygait analysislongitudinalstairs |
| spellingShingle | Matteo Zago Riccardo Di Giuli Giada Beltramini Alessandro Bolzoni Alessandro Baj Manuela Galli Aldo Bruno Giannì Chiarella Sforza Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional Outcome Symmetry free fibular flap morbidity gait analysis longitudinal stairs |
| title | Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional Outcome |
| title_full | Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional Outcome |
| title_fullStr | Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional Outcome |
| title_full_unstemmed | Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional Outcome |
| title_short | Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional Outcome |
| title_sort | donor site morbidity after osteocutaneous free fibula transfer longitudinal analysis of stair climbing asymmetry and functional outcome |
| topic | free fibular flap morbidity gait analysis longitudinal stairs |
| url | https://www.mdpi.com/2073-8994/14/9/1888 |
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