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.
RESULTS: 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.
CONCLUSIONS: 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.
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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
背景：在肿瘤手术中使用腓骨游离皮瓣进行头颈重建后安全行走的能力是患者的优先事项。此外,外科医生和患者需要客观了解功能性供体部位的发病率。然而,腓骨游离皮瓣手术对步态不对称的影响仅在步长和姿势持续时间方面进行了研究。这项研究分析了与年龄匹配的对照组相比，接受腓骨游离皮瓣重建的患者是否具有持久的步态不对称性。
方法：招募了在2019年至2023年之间使用腓骨游离皮瓣进行头颈部重建的患者，以及年龄匹配的控制。参与者以3公里/小时的速度在带仪表的跑步机上行走。主要结果指标是22个步态不对称指标。次要结果指标是步态不对称性与收获腓骨长度的关联，以及手术后的时间。
结果：13名招募的患者中有9名完成了完整的评估，没有抓住跑步机上的扶手。此外,纳入9个年龄匹配的对照.患者的22个步态不对称参数中有20个与健康对照相似，而推脱峰值力(p=0.008)和内侧脉冲不同(p=0.003)。步态不对称性与收获的腓骨长度无关。7个步态不对称参数与术后时间有很强的相关性。
结论：从长远来看，腓骨游离皮瓣重建对在跑步机上行走时与力相关的步态参数和时间步态参数的不对称性影响有限。
方法：招募了在2019年至2023年之间使用腓骨游离皮瓣进行头颈部重建的患者，以及年龄匹配的控制。参与者以3公里/小时的速度在带仪表的跑步机上行走。主要结果指标是22个步态不对称指标。次要结果指标是步态不对称性与收获腓骨长度的关联，以及手术后的时间。
结果：13名招募的患者中有9名完成了完整的评估，没有抓住跑步机上的扶手。此外,纳入9个年龄匹配的对照.患者的22个步态不对称参数中有20个与健康对照相似，而推脱峰值力(p=0.008)和内侧脉冲不同(p=0.003)。步态不对称性与收获的腓骨长度无关。7个步态不对称参数与术后时间有很强的相关性。
结论：从长远来看，腓骨游离皮瓣重建对在跑步机上行走时与力相关的步态参数和时间步态参数的不对称性影响有限。
