A New Method of Limb Salvage and Functional Upper Limb Reconstruction
82
creating a glass stick fracture and suturing the rib to-
gether in a fashion that straightens it but does not com-
promise its strength.
The ability of the reconstructed shoulder joint to sup-
port the weight of the arm was another concern in our
case. The Leed-Keio ligament is made of polyester woven
into an open mesh-like structure [17]. After implantation,
longitudinally aligned collagen-fiber bundles with spin-
dle-shaped nuclei form over the polyester matrix [18,19].
Use of this material permitted the strength of the artificial
joint to be preserved even after five years in our case.
Our report illustrates that the combined vascularized
rib-LD flap is useful in the reconstruction of large soft
tissue and bony defects that involve the upper limb and
the glenohumeral joint.
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