Document Detail

Devascularizing complications of free fibula harvest: peronea arteria magna.
MedLine Citation:
PMID:  16292729     Owner:  NLM     Status:  MEDLINE    
The authors present a case report of devascularizing complications following free fibula harvest. A retrospective review of 93 consecutively imaged limbs demonstrated a peronea arteria magna (PAM) prevalence of 5.3 percent in an urban population, which was used to perform a cost-effectiveness analysis for preoperative vascular imaging of the donor limb using magnetic resonance angiography (MRA) and traditional angiography (TA). Donor-site complications of fibula harvest range from 15 to 30 percent, but are rarely limb-threatening. Limb loss is a dreaded complication of congenital PAM, which can be present with a normal vascular exam. Some microsurgery groups advocate using no preoperative imaging of the donor limb; they rely on intraoperative assessment of the vascular anatomy. An aborted harvest due to aberrant anatomy leads to both direct and indirect added costs. The authors believe that MRA imaging of the donor limb, being minimally invasive, is cost-effective and indicated for free fibula transfers. For equivocal results, conversion to more invasive and costly TA may be necessary.
Gedge D Rosson; Navin K Singh
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of reconstructive microsurgery     Volume:  21     ISSN:  0743-684X     ISO Abbreviation:  J Reconstr Microsurg     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-18     Completed Date:  2006-02-21     Revised Date:  2011-02-16    
Medline Journal Info:
Nlm Unique ID:  8502670     Medline TA:  J Reconstr Microsurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-8     Citation Subset:  IM    
Division of Plastic, Reconstructive, and Maxillofacial Surgery, Johns Hopkins University School of Medicine, Outpatient Center, Baltimore, Maryland 21287, USA.
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MeSH Terms
Costs and Cost Analysis
Fibula / blood supply*,  transplantation
Leg / blood supply,  surgery
Magnetic Resonance Angiography
Microsurgery / methods
Postoperative Complications / diagnosis,  economics,  prevention & control*
Preoperative Care / economics,  methods
Reconstructive Surgical Procedures / adverse effects,  economics,  methods*
Retrospective Studies
Surgical Flaps / adverse effects*,  economics
Tibial Arteries / abnormalities,  anatomy & histology
Tissue and Organ Harvesting / adverse effects,  economics,  methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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