Precision repairing of compound tissue defect at limbs by 3-Dimentional contrast printing and fibular head compound tissue flap transplantation

Abstract

Objective To explore the clinical application and effect of fibular head compound soft tissue flap transplantation on precision repairing of compound tissue defect at limb joints assisted by 3 -Dimensional contrast printing technology. Methods From March, 2014 to September, 2017, 9 patients with bone and soft tissue defect at limb joints were selected. In which, 2 were distal radius bone defect with joint capsule and ligament defect, 2 were lower segment tibia bone and soft tissue defect, 2 were femur under section of the bone and soft tissue defect, 2 were medial malleolus bone and ligament defect, and 1 was external ankle ligament and bone defect. Using 3-Dimensional printing to conduct bilateral mirror-image contrast prior to the operation, morphology of bone defect at limb joints was acquired. Based on the texture printed out, corresponding fibular head compound blocks with blood vessels were removed from the donor site and transplanted to the recipient site before anastomosing the blood vessels and restoring the blood flow. The regular post-operative followed-up was performed. Results The 9 transplanted tissue blocks survived. The donor sites and the recipient sites were healed. The followed-up for restoration of limb function was from 9 to 35 (average, 17.5) months. The ankle function was assessed according Kofoed scale, resulted in 2 excellent and 1 good; The wrist function was assessed according Mayo scale, resulted in 1 excellent and 1 good. The medial malleolus bone defect and criteria bone defect were healed at 6 months. The patients were satisfied with the efficacy. Conclusion The application of 3-Dimensional contrast printing of fibular head compound tissue flap transplantation in repairing compound tissue defects at limb joints can reduce damage to the donor site, realizing precise repairing on limb tissue defect, and make good function restoration. Key words: Fibular head transplantation; 3-Dimensional printing; Tissue defects; Repair; Microsurgical technique