Abstract：
BACKGROUND: Vascularized fibula free flap (VFFF) remains gold standard for reconstruction of bony defects of the maxilla or mandible. Research and publications in recent years essentially focused on the evolution and improvement of the recipient reconstructed area but very few concerning the donor site morbidity.
OBJECTIVE: The aim of this study was to analyze walking ability of patients following VFFF operation and to determine if there are long term walking disabilities.
UNASSIGNED: The retrospective cohort study involved healthy controls and patients who had undergone VFFF between 2012 and 2019 at the oral and maxillo-facial department of the University Hospital in Lausanne, Switzerland. Patients with cardiovascular, pulmonary, neuromuscular or musculoskeletal pathologies that could impair walking were excluded from the study.
UNASSIGNED: Primary predictor is the reconstruction status, VFFF versus healthy patients (controls).
METHODS: Main outcomes were gait parameters. Objective evaluation of walking abilities was assessed using the Gait Up system (Gait Up SA, EPFL Innov\'Park-C, Lausanne, Switzerland), which are wearable motion sensors that provides 3D analytics of the gait.
UNASSIGNED: Covariates implied patient characteristics such as age, sex, time after surgery and subjective evaluation of the gait obtained with two orthopedic validated questionnaires.
RESULTS: This study implied 10 healthy controls and 11 patients who had undergone VFFF. Results showed statistically significant differences in the speed [m/s] (1.3 vs 1.1 for a P value of .001), the stride length [m] (1.4 vs 1.2 for a P value of 0.003), the flat foot phase [%] (55.0 vs 63.3 for a P value of .006) and the pushing phase [%] (34.1 vs 25.1 for a P value of .008).
CONCLUSIONS: Reconstruction using vascularized autograft in maxillofacial surgery is substantial and well described. Our attention focusing on donor site morbidity has demonstrated subjective and objective long-term alterations. These results will have to be confirmed with gait analysis in a prospective project including preoperative and postoperative analysis of the gait of the patient acting himself as his own control, with a larger scale of patients.
OBJECTIVE: The aim of this study was to analyze walking ability of patients following VFFF operation and to determine if there are long term walking disabilities.
UNASSIGNED: The retrospective cohort study involved healthy controls and patients who had undergone VFFF between 2012 and 2019 at the oral and maxillo-facial department of the University Hospital in Lausanne, Switzerland. Patients with cardiovascular, pulmonary, neuromuscular or musculoskeletal pathologies that could impair walking were excluded from the study.
UNASSIGNED: Primary predictor is the reconstruction status, VFFF versus healthy patients (controls).
METHODS: Main outcomes were gait parameters. Objective evaluation of walking abilities was assessed using the Gait Up system (Gait Up SA, EPFL Innov\'Park-C, Lausanne, Switzerland), which are wearable motion sensors that provides 3D analytics of the gait.
UNASSIGNED: Covariates implied patient characteristics such as age, sex, time after surgery and subjective evaluation of the gait obtained with two orthopedic validated questionnaires.
RESULTS: This study implied 10 healthy controls and 11 patients who had undergone VFFF. Results showed statistically significant differences in the speed [m/s] (1.3 vs 1.1 for a P value of .001), the stride length [m] (1.4 vs 1.2 for a P value of 0.003), the flat foot phase [%] (55.0 vs 63.3 for a P value of .006) and the pushing phase [%] (34.1 vs 25.1 for a P value of .008).
CONCLUSIONS: Reconstruction using vascularized autograft in maxillofacial surgery is substantial and well described. Our attention focusing on donor site morbidity has demonstrated subjective and objective long-term alterations. These results will have to be confirmed with gait analysis in a prospective project including preoperative and postoperative analysis of the gait of the patient acting himself as his own control, with a larger scale of patients.
摘要：
背景：血管化腓骨游离皮瓣（VFFF）仍然是重建上颌骨或下颌骨骨缺损的金标准。近年来的研究和出版物主要集中在受者重建区域的演变和改进上，但很少涉及供体部位的发病率。
目的：本研究的目的是分析VFFF手术后患者的步行能力，并确定是否存在长期步行障碍。
■回顾性队列研究涉及2012年至2019年在洛桑大学医院口腔和颌面部部门接受VFFF的健康对照和患者，瑞士。心血管患者，肺,本研究排除了可能损害行走的神经肌肉或肌肉骨骼病变.
■主要预测因子是重建状态，VFFF与健康患者(对照)的比较。
方法：主要结果是步态参数。使用步态系统评估步行能力的客观评估(GaitUpSA，EPFLInnov\'Park-C,洛桑,瑞士),它们是可穿戴的运动传感器，提供步态的3D分析。
■协变量隐含的患者特征，如年龄，性别,手术后的时间和步态的主观评估通过两个骨科验证问卷获得。
结果：本研究包含10名健康对照者和11名接受VFFF的患者。结果显示速度[m/s]的统计学差异（P值为.001时，1.3vs1.1），步幅[m]（P值为0.003时，为1.4vs1.2），平足阶段[%](P值为.006时55.0vs63.3)和推动阶段[%](P值为.008时34.1vs25.1)。
结论：在颌面外科中使用血管化自体移植进行重建是实质性的，并且有很好的描述。我们对供体部位发病率的关注已经证明了主观和客观的长期变化。这些结果必须通过前瞻性项目中的步态分析来确认，包括术前和术后对患者作为自己控制的步态进行分析，患者规模较大。
目的：本研究的目的是分析VFFF手术后患者的步行能力，并确定是否存在长期步行障碍。
■回顾性队列研究涉及2012年至2019年在洛桑大学医院口腔和颌面部部门接受VFFF的健康对照和患者，瑞士。心血管患者，肺,本研究排除了可能损害行走的神经肌肉或肌肉骨骼病变.
■主要预测因子是重建状态，VFFF与健康患者(对照)的比较。
方法：主要结果是步态参数。使用步态系统评估步行能力的客观评估(GaitUpSA，EPFLInnov\'Park-C,洛桑,瑞士),它们是可穿戴的运动传感器，提供步态的3D分析。
■协变量隐含的患者特征，如年龄，性别,手术后的时间和步态的主观评估通过两个骨科验证问卷获得。
结果：本研究包含10名健康对照者和11名接受VFFF的患者。结果显示速度[m/s]的统计学差异（P值为.001时，1.3vs1.1），步幅[m]（P值为0.003时，为1.4vs1.2），平足阶段[%](P值为.006时55.0vs63.3)和推动阶段[%](P值为.008时34.1vs25.1)。
结论：在颌面外科中使用血管化自体移植进行重建是实质性的，并且有很好的描述。我们对供体部位发病率的关注已经证明了主观和客观的长期变化。这些结果必须通过前瞻性项目中的步态分析来确认，包括术前和术后对患者作为自己控制的步态进行分析，患者规模较大。
