Dynamometric outcomes of the donor site leg after vastus lateralis free flap harvest

Ante Mihovilovic; Dinko Martinovic; Jure Martinic; Domagoj Markovic; Marko Tarle; Daniel Jerkovic; Sasa Vuk; Emil Dediol

doi:10.1016/j.jcms.2023.09.006

Dynamometric outcomes of the donor site leg after vastus lateralis free flap harvest

J Craniomaxillofac Surg. 2023 Dec;51(12):755-759. doi: 10.1016/j.jcms.2023.09.006. Epub 2023 Sep 9.

Authors

Ante Mihovilovic¹, Dinko Martinovic², Jure Martinic³, Domagoj Markovic⁴, Marko Tarle⁵, Daniel Jerkovic⁶, Sasa Vuk⁷, Emil Dediol⁸

Affiliations

¹ Department of Maxillofacial Surgery, University Hospital of Split, 21000, Split, Croatia; Department of Maxillofacial Surgery, University of Split School of Medicine, 21000, Split, Croatia. Electronic address: amihovilovic@kbsplit.hr.
² Department of Maxillofacial Surgery, University Hospital of Split, 21000, Split, Croatia; Department of Maxillofacial Surgery, University of Split School of Medicine, 21000, Split, Croatia.
³ Department of Oral Surgery, University of Split School of Medicine, 21000, Split, Croatia.
⁴ Department of Cardiovascular Diseases, University Hospital of Split, 21000, Split, Croatia.
⁵ Department of Maxillofacial Surgery, University Hospital Dubrava, 10000, Zagreb, Croatia.
⁶ Department of Oral Surgery, University of Split School of Medicine, 21000, Split, Croatia; Department of Oral Surgery, University Hospital of Split, 21000, Split, Croatia.
⁷ Department of Kinesiology of Sport, University of Zagreb Faculty of Kinesiology, 10000, Zagreb, Croatia.
⁸ Department of Maxillofacial Surgery, University Hospital Dubrava, 10000, Zagreb, Croatia; Department of Maxillofacial Surgery, University of Zagreb School of Medicine, 10000, Zagreb, Croatia.

PMID: 37704506
DOI: 10.1016/j.jcms.2023.09.006

Abstract

The vastus lateralis muscle is one of the four muscles that make up the quadriceps femoris muscle, and it is also the largest of them. Some studies have shown that patients experience lower quality of life and muscle weakness after surgical treatment of thigh muscles in order to perform reconstructive surgery of the head and neck. The aim of our study was to assess the quantitative and qualitative function of the lower extremities using an isokinetic dynamometer and a validated questionnaire on subjective difficulties in patients who underwent reconstructive surgery with the vastus lateralis free flap. Fourteen participants aged 20-70 years who suffered from malignant tumor in the head and neck region. The free vastus lateralis flap was used for reconstruction. All patients underwent isokinetic dynamometric measurement with the isokinetic dynamometer to test the isokinetic functions of the thigh muscles after surgery. In addition, subjective assessment of the lower extremities was performed using the validated questionnaire Lower Extremity Functional Scale. All isometric dynamometer measurements of the donor leg were compared with those of the unoperated leg. Peak torque and average power were significantly lower in the operated leg compared with the unoperated leg after 60°/s extension (p = 0.018 for peak torque, p = 0.021 for average power) and 180°/s extension (p = 0.019 for peak torque, p = 0.015 for average power). On the other hand, there was no statistically significant difference in dynamometer measurements after 60°/s flexion (p = 0.700 for peak torque, p = 0.854 for average power, and 180°/s flexion (p = 0.634 for peak torque, p = 0.571 for average power). The median value for the LEFS was 65.5 (40.00-71.25). The results of this study showed that there is a significant deterioration regarding the biophysical properties of the operated leg after harvesting vastus lateralis free flap.

Keywords: Isokinetic function; Lower extremity; Reconstructive head and neck surgery; Strength assessment; Vastus lateralis free flap.

MeSH terms

Humans
Leg* / physiology
Muscle, Skeletal
Quality of Life*
Surgical Flaps
Thigh
Torque