Gait changes in patients after reconstruction of facial bones with fibula and iliac crest free vascularized flaps

• Autorzy: Syczewska M. , Krajewski R. , Szczerbik E. , Kalinowska M.

Identyfikatory

DOI

10.5277/ ABB-01062-2017-02

• Języki publikacji: EN

Abstrakty

EN

Patients with malignant tumours of the oral cavity require its surgical removal and reconstruction of the bone and soft tissues. The grafts are obtained either from leg (fibula) or pelvis (iliac crest). The removal of grafts from the locomotor apparatus can impair the gait. The aim of this study was to find out how the localization of donor site influences the gait pattern. Methods: Results obtained for 30 patients were analyzed (16 fibula graft, 14 iliac crest graft). Patients underwent instrumented gait analyses three times (VICON system): before surgery, 2–4 month after the surgery, and 4–8 months after the surgery. Results: In both groups several gait parameters were changed. Two parameters changed in both groups: gait speed and cadence. In patients receiving iliac crest graft the changed gait variables were: pelvic rotation, hip range in sagittal plane (operated side), knee range in sagittal plane (operated side), foot dorsiflexion in swing on both sides. In patients receiving fibula flap the changed gait variables were: tilt, range motion of the tilt, minimum hip flexion (operated side), time to maximum knee flexion (non-operated side), GGI (non-operated side) and step length (nonoperated side). Conclusions: The primary gait deviations occurring after surgery, and the compensatory mechanisms which subsequently arise depend on the localization of graft donor site. The results indicate that the patients in whom fibula flap was used have less problems with gait pattern after the surgery than the patients receiving iliac crest graft.

Słowa kluczowe

EN

gait pattern; reconstructive surgery; malignant tumour; oral cavity

PL

wzorzec chodu; chirurgia rekonstrukcyjna; nowotwór złośliwy; jama ustna

• Wydawca: Oficyna Wydawnicza Politechniki Wrocławskiej
• Czasopismo: Acta of Bioengineering and Biomechanics
• Rocznik: 2018
• Tom: Vol. 20, no. 1
• Strony: 185--190
• Opis fizyczny: Bibliogr. 8 poz., wykr.

Twórcy

autor

Syczewska M.

• Department Rehabilitation, The Children’s Memorial Health Institute The Children’s Memorial Health Institute, Warsaw, Poland

autor

Krajewski R.

• Department Head and Neck Cancer, Cancer Center M. Sklodowska-Curie Memorial Institute, Warsaw, Poland

autor

Szczerbik E.

• Department Physical Therapy, Cancer Center M. Sklodowska-Curie Memorial Institute, Warsaw, Poland

autor

Kalinowska M.

• Department Rehabilitation, The Children’s Memorial Health Institute The Children’s Memorial Health Institute, Warsaw, Poland

Bibliografia

• [1] ARCHER K.R., CASTILLO R.C., MACKENZIE E.J., BOSSE M.J. et al., Gait symmetry and walking speed analysis following lower-extremity trauma, Physical Therapy, 2006, 86, 1630–1640.
• [2] HAJDUK G., NOWAK K., SOBOTA G., KUSZ D., KOPEĆ K., BŁASZCZAK E., CIELIŃSKI Ł., BACIK B., Kinematic gait parameters changes in patients after total knee arthroplasty. Comparison between cruciate-retaining and posterior-substituting design, Acta Bioeng. Biomech., 2016, 18, 137–142.
• [3] KRAMERS DE QUERVIAN I.A., LAUFFER J., KACH K., TRENTZ O., STUSSI E., Functional donor-site morbidity during level and uphill gait after a gastrocnemius or soleus muscle-flap procedure, J. Bone Jt. Surg. Am., 2001, 83.2, 239–246.
• [4] LEE J.-H., CHUNG C.-Y., MYOUNG H., KIM M.-J., YUN P.-Y., Gait analysis of donor leg after free fibula flap transfer, Int. J. Oral. Maxillofac. Surg., 2008, 37, 625–629.
• [5] http://microsurgeon.org/
• [6] ÖBERG T., KARSZNIA A., ÖBERG K., Basic gait parameters: reference data for normal subjects, 10–79 years of age, J. Rehabil. Res. 1993, 30, 210–23.
• [7] SCHUTTE L.M., NARAYANAN U., STOUT J.L., SELBER P., GAGE J.R., SCWARTZ M.H., An index quantifying deviations from normal gait, Gait Posture, 2000, 11, 25–31.
• [8] SYCZEWSKA M., DEMBOWSKA-BAGIŃSKA B., PEREK-POLNIK M., KALINOWSKA M., PEREK D., Gait pathology assessed with Gillette Gait Index in patients after CNS tumour treatment, Gait Posture, 2010, 32, 358–362.

Uwagi

The study was supported by the research grant NN403397039 of Polish Ministry of Sciences. The upgrade of the VICON system, was co-financed by ERDF (EU Structural Funds) project POIG.02.01.00-14-059/09.

Opracowanie rekordu w ramach umowy 509/P-DUN/2018 ze środków MNiSW przeznaczonych na działalność upowszechniającą naukę (2018).