RESUMO
BACKGROUND: The anterolateral thigh (ALT) free flap has been an extremely versatile flap. The purpose of this study was to propose comprehensive functional assessments of the donor site. METHODS: A total of 33 ALT flaps were enrolled prospectively. Objective assessments included isokinetic testing of the knee, and electromyographic examination of the lateral femoral cutaneous nerve (LFCN). The Patient and Observer Scar Assessment Scale (POSAS) was used to subjectively assess the donor-site scar. RESULTS: On the donor side, a significant decrease in most isokinetic muscle strength values was obvious 1 year postoperatively (P < .01). The normal side showed a compensatory increase 1 year postoperatively in the majority of isokinetic muscle strength values (P < .05). The majority of patients (70%) showed decreased sensory conduction velocity of the LFCN or no response to the microcurrent stimulation postoperatively. The aesthetic outcome was satisfactory. CONCLUSION: The decline in functional parameters at the donor-site was common. However, much more research is needed.
Assuntos
Nervo Femoral/fisiopatologia , Retalhos de Tecido Biológico , Força Muscular/fisiologia , Condução Nervosa/fisiologia , Sítio Doador de Transplante/fisiopatologia , Adulto , Idoso , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Coxa da PernaRESUMO
BACKGROUND: The free fibula flap has become popular for mandibular reconstruction. The purpose of this study was to propose comprehensive functional assessments of the donor site. METHODS: Thirty free fibula flaps for mandible reconstruction were prospectively enrolled in the study. Objective assessments included isokinetic testing of the ankle joint, electromyographic examination of the superficial peroneal nerve (SPN), and preoperative and postoperative foot scans. The Patient and Observer Scar Assessment Scale (POSAS) was used to subjectively assess the donor site. RESULTS: The isokinetic values of the donor side showed a significant decrease 1 year postoperatively. The results of the electromyographic test of the SPN were categorized as 3 types. The plantar center pressure shifted to the heel on the donor side 6 months postoperatively. The aesthetic outcome was satisfactory. CONCLUSION: The functional parameters of the donor site indeed declined in our assessments. Further refinements in the surgical technique are needed to improve the donor site status. © 2016 Wiley Periodicals, Inc. Head Neck 39: 279-287, 2017.