Free deep circumflex iliac artery vascularised bone flap for reconstruction of the distal radius: planning with CT angiography

Ting, Jeanette W.C., Rozen, Warren M., Leong, James, and Crock, John (2009) Free deep circumflex iliac artery vascularised bone flap for reconstruction of the distal radius: planning with CT angiography. Microsurgery, 30 (2). pp. 163-167.

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View at Publisher Website: http://dx.doi.org/10.1002/micr.20731
 
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Abstract

Distal radius fractures in the younger population are often comminuted and intra-articular, which can increase the complexity of their management. In addition, these patients tend to place high demands on their wrists, and the prevention of functional arthritis necessitates excellent anatomical reduction. Complicated cases such as these are often limited in their management options. We present a complex case of distal radius fracture and bone loss in which initial therapy with nonvascularized bone graft failed, and osteomyelitis was a further complicating factor. With the aid of preoperative planning with computed tomographic angiography (CTA), a deep circumflex iliac artery (DCIA) bone flap was able to be assessed as a reconstructive option. The use of preoperative CTA, the first description of such imaging in this role, was able to delineate the bone to be harvested, confirm its vascular supply, and plan flap harvest. The use of a vascularized bone flap in this setting was thus undertaken and was able to provide an autologous anatomical support for the wrist while reducing the risk of recurrent infection and still preserving internal fixation. This unique application of the free DCIA bone flap was potentiated by CTA, achieving complete healing and good functional outcomes.

Item ID: 32414
Item Type: Article (Research - C1)
ISSN: 1098-2752
Date Deposited: 28 Apr 2014 23:47
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110320 Radiology and Organ Imaging @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 50%
97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 50%
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