Free vascularized fibula grafts in limb-salvage surgery.
The authors review the outcome of a consecutive series of 24 free vascularized fibular grafts performed as part of a limb-salvage procedure following tumor excision. There were 15 women and nine men with a mean age of 26 years (range: 6 to 52 years). The minimum follow-up was 12 months. The mean length of the graft was 13.1 cm. (range: 4.5 to 25 cm). Fifteen grafts were used in the upper limb, eight in the lower limb, and one in the pelvis. Bony union was achieved in 21/24 patients at a mean of 9.3 months. Complications occurred in 13/24 patients of whom 11 required a second operation. Four patients died of metastatic disease. The mean Musculoskeletal Tumor Society (MSTS) functional score in the remaining 20 was 84.5 percent, with 16 patients having a good or excellent outcome. Free vascularized fibula grafts offer a reliable method of reconstruction after excision of bone tumors. Although the incidence of complications appears high, they are relatively easy to correct, bony union is achieved in the majority, and functional outcome is good.
Pollock
Rob
R
Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Missenden Rd, Sydney, Australia.
Stalley
Paul
P
Lee
Ken
K
Pennington
David
D
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology* / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D016009:Chi-Square Distribution; D002648:Child; D015331:Cohort Studies; D005260:Female; D005360:Fibula / Q000098:blood supply* / Q000637:transplantation*; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D034941:Upper Extremity