Free Vascularized Fibula Salvage of Failed CPH in Pediatric Sarcoma Patients

Table 3

Postoperative course and associated complications.

Patient	Postoperative complications	Treatment of complications	Reoperation details	Total # of associated reoperations	Time to osseous union (months)
1	Lost Doppler signal	Reoperation	Venous Doppler repositioning^a	1	4.6
	Hypotension	Transfusion of 1 pRBC	—		—
2	Partial tissue necrosis	Conservative management	—	0	2.9
3	Skin paddle venous congestion	Reoperation	Skin paddle resection with advancement flap^b		—
	Nonunion and fracture	Planned reoperation		2	—
4	Lost Doppler signal	Reoperation	Hematoma evacuation, flap vein thrombectomy and reanastomosis	1	5.3
5	Radial nerve palsy	Conservative management	—	0	1.9

Lost to follow-up before undergoing reoperation and achieving evidence of osseus union. ^aExploration of the right arm fibula flap revealed venous Doppler shifted in position but artery and vein were patent on exploration. ^bExploration revealed thrombosis of tiny perforator vessels with widely patent flap vessels. Skin paddle resected using Bovie, and an anterior skin subcutaneous tissue advancement flap 15 × 6 cm for right arm closure.