Evidence map›Paper›PMID 40909758›Full record

ReviewJPRAS open2025

Ankle instability and gait disturbance after free fibula flap reconstruction in head and neck cancer reconstruction: A systematic review.

Sebastian Holm, Jenny Löfgren, Fredrik Landström, Rodi Ali, Reza Tabrisi, Alexander Wyckman, Nikoo Bazsefidpay, Johann Zdolsek, Juan Enrique Berner

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in JPRAS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sebastian HolmDepartment of Plastic and Reconstructive Surgery, Örebro University Hospital, Örebro, Sweden.
Jenny LöfgrenDepartment of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Fredrik LandströmFaculty of Medicine and Health, Örebro University, Örebro, Sweden.
Rodi AliDepartment of Plastic and Reconstructive Surgery, Örebro University Hospital, Örebro, Sweden.
Reza TabrisiDepartment of Plastic and Reconstructive Surgery, Örebro University Hospital, Örebro, Sweden.
Alexander WyckmanDepartment of Hand Surgery, Plastic Surgery and Burns and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Nikoo BazsefidpayFaculty of Medicine and Health, Örebro University, Örebro, Sweden.
Johann ZdolsekDepartment of Plastic and Reconstructive Surgery, Örebro University Hospital, Örebro, Sweden.
Juan Enrique BernerDivision of Plastic Surgery, Department of Surgery, University of Texas Health Science Center, San Antonio, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The free fibula flap is a workhorse flap for bony reconstruction of the craniofacial skeleton. The aim of the study was to conduct a systematic review to investigate the postoperative donor site complications and functional outcomes, specifically ankle instability (AI) and gait disturbances (GD), for patients who have received a free fibula flap (FFF) for head and neck cancer reconstruction. Methods: We designed a PRISMA-compliant systematic review, which was registered prospectively in PROSPERO. Searches were designed with a health science librarian and included MEDLINE, EMBASE, CINAHL and PEDro. Risk of bias assessment was conducted for each included study, with an assessment of quality using GRADE. Results: Following exclusion of duplicate entries, a total of 1940 abstracts were identified. After parallel blinded eligibility assessment, 32 studies were included in the analysis. The total number of included participants was 1163, with the total number of FFF being 955. The mean time for functional assessment was 35 months postoperatively (range 8-81 months). The subjective and objective assessment modalities varied considerably. The primary result for AI were 3.3 % and 5.5 % for GD. The results demonstrate heterogeneity in the literature regarding the reporting of AI and GD following FFF. Conclusion: According to this review, the risk of developing these complications appears to be limited but underreporting may be a limitation. Consensus on methods for standardized outcomes assessment of FFF-reconstruction is needed to establish the impact of free fibula flap on AS and GD.

Indexed as

Ankle instabilityComplicationsDonor site morbidityGait disturbanceHead and neck reconstructionMicrosurgery

Identifiers

PMID40909758
PMCPMC12405634

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.