Gait asymmetries after fibular free flap harvest: A cross-sectional observational study

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-05-01 DOI:10.1016/j.clinbiomech.2024.106259
Elke Warmerdam , Dominik Horn , Ramona Filip , Kolja Freier , Bergita Ganse , Carolina Classen
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Abstract

Background

The ability to walk safely after head and neck reconstruction with fibular free flaps in tumor surgery is a high priority for patients. In addition, surgeons and patients require objective knowledge of the functional donor-site morbidity. However, the effects of fibular free flap surgery on gait asymmetries have only been studied for step length and stance duration. This study analyses whether patients who have undergone fibular free flap reconstruction have enduring gait asymmetries compared to age-matched controls.

Methods

Patients who underwent head and neck reconstruction with fibular free flaps between 2019 and 2023 were recruited, as well as age-matched controls. Participants walked on an instrumented treadmill at 3 km/h. The primary outcome measures were 22 gait asymmetry metrics. Secondary outcome measures were the associations of gait asymmetry with the length of the harvested fibula, and with the time after surgery.

Findings

Nine out of 13 recruited patients completed the full assessment without holding on to the handrail on the treadmill. In addition, nine age-matched controls were enrolled. Twenty out of the 22 gait asymmetry parameters of patients were similar to healthy controls, while push-off peak force (p = 0.008) and medial impulse differed (p = 0.003). Gait asymmetry did not correlate with the length of the fibula harvested. Seven gait asymmetry parameters had a strong correlation with the time after surgery.

Interpretation

On the long-term, fibular free flap reconstruction has only a limited effect on the asymmetry of force-related and temporal gait parameters while walking on a treadmill.

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腓骨游离皮瓣摘除术后的步态不对称:横断面观察研究
背景在肿瘤手术中使用腓骨游离皮瓣进行头颈部重建后,能否安全行走是患者最关心的问题。此外,外科医生和患者都需要客观了解供体部位的功能性发病率。然而,关于腓骨游离瓣手术对步态不对称的影响,目前仅有针对步长和站立时间的研究。本研究分析了与年龄匹配的对照组相比,接受过腓骨游离皮瓣重建术的患者是否存在持久的步态不对称。方法招募了2019年至2023年期间接受头颈部腓骨游离皮瓣重建术的患者以及年龄匹配的对照组。参与者在带仪器的跑步机上以 3 公里/小时的速度行走。主要结果指标为22项步态不对称指标。次要结果测量步态不对称性与所采集腓骨的长度以及术后时间的关系。研究结果13名被招募的患者中有9人在没有扶住跑步机扶手的情况下完成了全部评估。此外,还招募了九名年龄匹配的对照组患者。在22个步态不对称参数中,患者的20个参数与健康对照组相似,而推离峰值力(p = 0.008)和内侧冲力(p = 0.003)则不同。步态不对称与截取的腓骨长度无关。从长期来看,腓骨游离瓣重建对在跑步机上行走时与力量相关的步态参数和时间步态参数的不对称性影响有限。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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