Femoral reconstruction by vascularized bone transfer.
Thirty-five patients with extensive femoral defects or recalcitrant nonunions were reconstructed by microvascular bone transfer with a follow-up period exceeding 12 months. The cause of bone defect included trauma, debridement for osteomyelitis, or tumor resection, and the cause of nonunion included trauma or postirradiation osteonecrosis. Sixty-nine percent of patients healed primarily, whereas 83% of patients ultimately progressed to union following secondary surgery. One patient who initially healed later required amputation for late graft fracture with nonunion; therefore, at final follow-up, 80% of patients were fully healed. Vascularized bone transfer merits strong consideration for reconstruction of atypical and particularly difficult femoral nonunions.
Wood
M B
MB
Department of Orthopedic Surgery, Mayo Clinic/Mayo Foundation, Rochester, MN.
D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000601:surgery; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery; D013997:Time Factors; D014945:Wound Healing