title: Double-strut free vascular fibular grafting for reconstruction of the lower extremities.
abstract: This article reports our experience on the treatment of long-bone defects with double-strut vascular fibular graft in 11 patients. The defects were 6-12 cm in length while 10-25 cm of vascular fibular grafts were harvested. Nine patients achieved solid union in 6 months, and two patients required additional procedures to achieve solid union. No major complications were observed, except for three patients. who had knee stiffness due to long-term immobilization and one patient who had experienced a stress fracture because of strenuous exercise at 10 months after grafting procedures. Bone union in this patient was achieved 3 months after reapplying an external fixator. It is suggested that a rigid external or internal fixator is mandatory in the course of treatment for facilitating early knee mobilization to prevent exacerbation of already compromised knee-joint motion. Vigorous exercise should be avoided for at least 12 months after solid union of the graft to prevent graft fracture. We concluded that the double-strut vascular fibular graft is an effective treatment for complicated long-bone defects of lower extremity.
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome