title: Postoperative results of vascularized double fibula grafts for femoral pseudoarthrosis with large bony defect.
abstract: In open femoral bone fractures osteomyelitis may develop as a complication. Many difficulties are experienced in the treatment of those fractures because an extended bone defect may be formed after repeated operations, and then amputation of the femoral bone becomes necessary. Since 1981 the present authors have performed the vascularized double fibula grafts in the treatment of 18 patients with successful results. With this grafting method, both vascularized double fibula grafts are collected at the same time, one as an intramedullary graft and the other as an onlay graft. The most important point in carrying out grafting by this method is to prepare the recipient bone bed adequately. In many cases, it is necessary to carry out the primary operation to curette the focus, and resect necrotic tissues and sequestrated bone before the vascularized double fibula grafts, and then grafting is performed as a second operation after infection has been controlled following the initial operation. Although differences in time required for recovery cannot be eliminated completely, it becomes possible for 16 out of 18 patients to walk without the use of a brace and crutches within 13 months on average.
authors.affiliation: Department of Orthopaedic Surgery, Jikei University, School of Medicine, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tomita
authors.forename: K
authors.initials: K
authors.lastname: Murota
authors.forename: F
authors.initials: F
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Moriyama
authors.forename: M
authors.initials: M
authors.lastname: Beppu
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005360:Fibula / Q000637:transplantation*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011542:Pseudarthrosis / Q000601:surgery*; D016896:Treatment Outcome