title: Treatment of large skeletal defects in the lower extremities using double-strut, free vascularized fibular bone grafting.
abstract: This article reports on the use of double-strut, free vascularized fibular grafts to treat six patients with infected nonunion or traumatic bone loss in the femur or tibia after prolonged treatment and multiple operations. The defects were 6-13 cm long. Five patients achieved solid union within 6 months, and one patient required additional cancellous grafting to achieve union at the distal end of the fibula. One patient experienced a stress fracture due to strenuous exercise, and union was achieved 3 months after reapplying an external fixator. Although three patients had some restricted knee motion, all patients had a satisfactory outcome in regard to walking, and no limb-length discrepancies were noted in any patient.
authors.affiliation: Department of Orthopedics and Traumatology, Veterans General Hospital-Taipei, Taiwan, ROC.
authors.forename: M C
authors.initials: MC
authors.lastname: Chang
authors.forename: W H
authors.initials: WH
authors.lastname: Lo
authors.forename: C M
authors.initials: CM
authors.lastname: Chen
authors.forename: T H
authors.initials: TH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome