title: Free vascularized fibula grafts in surgery of the upper limb.
abstract: Twenty patients with intractable diseases in the upper extremity were treated using free vascularized fibula grafts. There were 13 men and seven women. Three patients had traumatic bone defects, five had post-traumatic nonunions, two had congenital pseudoarthroses, seven had defects after tumor resection, and three had other lesions. The reconstructed sites were the humerus in two patients, the radius and/or ulna in 17, and the metacarpal and phalangeal bones in one. The length of the bone defect ranged from 3 to 18 cm (mean: 8.4 cm). Follow-up periods ranged from 6 to 204 months. No patient required additional bone grafts. The mean period required to obtain radiographic bone union was 4.4 months. There were no cases with fractures of the grafted bone, but malunion occurred in four cases. The vascularized fibula graft is indicated in patients with large bone defects or intractable nonunions in the humerus, radius, and/or ulna.
authors.affiliation: Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yajima
authors.forename: S
authors.initials: S
authors.lastname: Tamai
authors.forename: H
authors.initials: H
authors.lastname: Ono
authors.forename: K
authors.initials: K
authors.lastname: Kizaki
authors.forename: T
authors.initials: T
authors.lastname: Yamauchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D005360:Fibula / Q000098:blood supply* / Q000637:transplantation*; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011884:Radius / Q000002:abnormalities / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome; D014654:Vascular Patency; D014953:Wrist / Q000601:surgery