Free Vascularized Fibular Flap with Bilateral Bipolar Latissimus Transfer for Upper Extremity Reconstruction: A Case Report

Parinaz J. Dabestani; Matthew D. Ramsey; Ava G. Chappell; Megan E. Fracol; Michael D. Stover; Jason H. Ko

doi:10.2106/JBJS.CC.22.00286

Free Vascularized Fibular Flap with Bilateral Bipolar Latissimus Transfer for Upper Extremity Reconstruction: A Case Report

Parinaz J. Dabestani, Matthew D. Ramsey, Ava G. Chappell, Megan E. Fracol, Michael D. Stover, Jason H. Ko^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Case:A 19-year-old woman presented with bilateral mangled upper extremities after jumping in front of a moving train. After revascularization, osteocutaneous free vascularized fibula flap was performed to reconstruct the right humerus. The left forearm required transradial amputation with acute targeted muscle reinnervation. Finally, staged bilateral bipolar latissimus dorsi functional muscle flaps were performed to restore elbow flexion.Conclusion:Staged orthoplastic reconstruction of the upper extremities is an effective treatment approach for traumatic bone and soft-tissue defects. This patient's recovery demonstrates improved quality of life after severe upper extremity trauma.

Original language	English (US)
Article number	00286
Journal	JBJS case connector
Volume	12
Issue number	4
DOIs	https://doi.org/10.2106/JBJS.CC.22.00286
State	Published - Oct 7 2022

Keywords

TMR
bipolar latissimus muscle transfer
elbow flexion
functional muscle transfer
mangled upper extremity
targeted muscle reinnervation
transradial amputation
vascularized bone
vascularized fibula

ASJC Scopus subject areas

Surgery
Orthopedics and Sports Medicine

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10.2106/JBJS.CC.22.00286

Cite this

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title = "Free Vascularized Fibular Flap with Bilateral Bipolar Latissimus Transfer for Upper Extremity Reconstruction: A Case Report",

abstract = "Case:A 19-year-old woman presented with bilateral mangled upper extremities after jumping in front of a moving train. After revascularization, osteocutaneous free vascularized fibula flap was performed to reconstruct the right humerus. The left forearm required transradial amputation with acute targeted muscle reinnervation. Finally, staged bilateral bipolar latissimus dorsi functional muscle flaps were performed to restore elbow flexion.Conclusion:Staged orthoplastic reconstruction of the upper extremities is an effective treatment approach for traumatic bone and soft-tissue defects. This patient's recovery demonstrates improved quality of life after severe upper extremity trauma.",

keywords = "TMR, bipolar latissimus muscle transfer, elbow flexion, functional muscle transfer, mangled upper extremity, targeted muscle reinnervation, transradial amputation, vascularized bone, vascularized fibula",

author = "Dabestani, {Parinaz J.} and Ramsey, {Matthew D.} and Chappell, {Ava G.} and Fracol, {Megan E.} and Stover, {Michael D.} and Ko, {Jason H.}",

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doi = "10.2106/JBJS.CC.22.00286",

language = "English (US)",

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T2 - A Case Report

AU - Dabestani, Parinaz J.

AU - Ramsey, Matthew D.

AU - Chappell, Ava G.

AU - Fracol, Megan E.

AU - Stover, Michael D.

AU - Ko, Jason H.

PY - 2022/10/7

Y1 - 2022/10/7

N2 - Case:A 19-year-old woman presented with bilateral mangled upper extremities after jumping in front of a moving train. After revascularization, osteocutaneous free vascularized fibula flap was performed to reconstruct the right humerus. The left forearm required transradial amputation with acute targeted muscle reinnervation. Finally, staged bilateral bipolar latissimus dorsi functional muscle flaps were performed to restore elbow flexion.Conclusion:Staged orthoplastic reconstruction of the upper extremities is an effective treatment approach for traumatic bone and soft-tissue defects. This patient's recovery demonstrates improved quality of life after severe upper extremity trauma.

AB - Case:A 19-year-old woman presented with bilateral mangled upper extremities after jumping in front of a moving train. After revascularization, osteocutaneous free vascularized fibula flap was performed to reconstruct the right humerus. The left forearm required transradial amputation with acute targeted muscle reinnervation. Finally, staged bilateral bipolar latissimus dorsi functional muscle flaps were performed to restore elbow flexion.Conclusion:Staged orthoplastic reconstruction of the upper extremities is an effective treatment approach for traumatic bone and soft-tissue defects. This patient's recovery demonstrates improved quality of life after severe upper extremity trauma.

KW - TMR

KW - bipolar latissimus muscle transfer

KW - elbow flexion

KW - functional muscle transfer

KW - mangled upper extremity

KW - targeted muscle reinnervation

KW - transradial amputation

KW - vascularized bone

KW - vascularized fibula

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Free Vascularized Fibular Flap with Bilateral Bipolar Latissimus Transfer for Upper Extremity Reconstruction: A Case Report

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

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