• Profile
Close

Association of the anterolateral thigh osteomyocutaneous flap with femur structural integrity and assessment of prophylactic fixation

JAMA Otolaryngology—Head & Neck Surgery Aug 02, 2018

Worley ML, et al. - Authors gauged the correlation of anterolateral thigh osteomyocutaneous (ALTO) flap harvest, with and without prophylactic fixation, on femur structural integrity as measured by a 4-point bend and torsional biomechanical testing. Significant changes in the structural integrity of the femur were resulted by anterolateral thigh osteomyocutaneous flap harvest. Findings suggested a strong consideration of postoperative stabilization.

Methods

  • Twenty four synthetic fourth-generation composite femurs with validated biomechanical properties at a research laboratory, underwent 10-cm-long, 30% circumferential osteotomies at the proximal middle third of the femur; 6 femurs served as controls.
  • Torsional and 4-point bend biomechanical testing were carried out in osteotomized femurs with and without fixation.
  • Intramedullary nail and distal interlock screw placement was consisted by femur fixation.
  • They compared the force and torque to fracture (expressed in kilonewtons [kN] and Newton meters [N.m], respectively) between controls, osteotomized femurs without fixation, and osteotomized femurs with fixation.
  • Femur stiffness and fracture patterns were included in the additional outcome measures.

Results

  • Findings suggested that on posterior to anterior (PA) 4-point bend testing, force to fracture of osteotomized femurs was 22% of controls (mean difference, 8.3 kN; 95% CI, 6.6-10.0 kN).
  • As per data, on torsional testing the torque to fracture of osteotomized femurs was 12% of controls (mean difference, 351.1 N.m; 95% CI, 307.1-395.1 N.m).
  • After fixation there was a 67% improvement in PA force to fracture and a 37% improvement in torque to fracture.
  • Nonetheless, results demonstrated that osteotomized femurs with fixation continued to have a reduced PA force to fracture at 37% of controls (mean difference, 6.8 kN; 95% CI, 4.5-9.2 kN) and torque to fracture at 16% of controls (mean difference, 333.7 N.m; 95% CI, 306.8-360.6 N.m).
  • On torsional testing, similar spiral fractures through a corner of the distal osteotomy site were developed in all osteotomized femurs.
  • They noted a change in this fracture pattern after prophylactic fixation with femurs developing nondisplaced fractures through the proximal osteotomy site.
  • During testing of osteotomized femurs with fixation, there were no underlying hardware failures.

Go to Original
Only Doctors with an M3 India account can read this article. Sign up for free or login with your existing account.
4 reasons why Doctors love M3 India
  • Exclusive Write-ups & Webinars by KOLs

  • Nonloggedininfinity icon
    Daily Quiz by specialty
  • Nonloggedinlock icon
    Paid Market Research Surveys
  • Case discussions, News & Journals' summaries
Sign-up / Log In
x
M3 app logo
Choose easy access to M3 India from your mobile!


M3 instruc arrow
Add M3 India to your Home screen
Tap  Chrome menu  and select "Add to Home screen" to pin the M3 India App to your Home screen
Okay