title: Secondary reconstruction after vascularized fibular transfer.
abstract: We evaluated the results of skeletal reconstruction performed through a mature, vascularized fibular graft in five patients. The average time-interval between the original transplant and the secondary reconstruction was sixty-eight months. The indication for the initial graft had been the loss of bone secondary to trauma in one patient, a skeletal defect due to ablation of a tumor in two patients, and osseous loss due to resection of a congenital pseudarthrosis in two patients. The indication for the second reconstruction was non-union of a fracture as a result of a new traumatic injury in two patients and complex angular deformity in three patients; one of the patients in the latter group had an associated leg-length discrepancy. In all five patients, the second reconstruction was successful, and the vascularized fibular graft responded to the procedure in a manner similar to normal cortical bone.
authors.affiliation: Orthopaedic Trauma Service, Massachusetts General Hospital, Boston 02114.
authors.forename: J B
authors.initials: JB
authors.lastname: Jupiter
authors.forename: M A
authors.initials: MA
authors.lastname: Palumbo
authors.forename: J A
authors.initials: JA
authors.lastname: Nunley
authors.forename: P L
authors.initials: PL
authors.lastname: Aulicino
authors.forename: J E
authors.initials: JE
authors.lastname: Herzenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001847:Bone Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001859:Bone Neoplasms / Q000601:surgery; D001842:Bone and Bones / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005593:Fracture Fixation, Internal; D005599:Fractures, Ununited / Q000601:surgery; D006801:Humans; D006984:Hypertrophy; D007870:Leg Length Inequality / Q000601:surgery; D008297:Male; D010027:Osteotomy; D011183:Postoperative Complications / Q000601:surgery*; D011542:Pseudarthrosis / Q000601:surgery; D011859:Radiography; D012086:Reoperation