Assessment of Donor Leg Function after Vascularized Fibular Osteoseptocutaneous Flap Harvest Using Balance Test and Gait Analysis – A Prospective Study

The free vascularized fibular osteoseptocutaneous flap has been widely used as a source for bone defect reconstruction of the mandible and extremities. Although low donor-site morbidity has been documented in the literature, this has been mostly in retrospective studies, with prospective studies of donor leg function assessment sparse.

Ten consecutive patients scheduled to receive free vascularized osteoseptocutaneous fibular flaps for mandible reconstruction since November 2003 were included. There were 8 males and 2 females, with a mean age of 47 years (range: 20 to 65 years). The balance test with Smart Balance Master and gait analysis were used for objective assessment of donor leg function preoperatively and 1 year postoperatively.

No statistically significant differences were observed in the kinematic variables of gait analysis, including ankle joint angles and temporal stride analysis (velocity, step length, cadence, stride time, single and double support times) and the kinetic variables of ground reaction forces. There were also no significant differences in static balance test (eyes open, eyes closed, swaying vision, eyes open with swaying surface, eyes closed with sway-referenced support and sway-referenced vision and support). In the dynamic balance test, only specificity of forward right direction determined significant difference in reaction time of movement control of gravity between preoperative and 1-year postoperative follow-up.

There was only mild functional deficit in activities of daily life after fibular osteospeptocutaneous flap harvest at 1-year follow-up. Repeated long-term and stress studies such as jogging and climbing are ongoing.