Free vascularized fibula grafts for salvage of failed oncologic long bone reconstruction and pathologic fractures.
Vascularized bone grafts, particularly the free fibula transfer, have incited revolutionary changes in the field of skeletal reconstruction. In no place has this been more evident than in oncologic reconstruction. The free vascularized fibula graft has been used to good effect for primary long-bone reconstruction, long-bone allograft complication salvage, and pathologic fracture salvage of the long bones. Although many of these procedures often entail significant complications, limb salvage has been made possible in a majority of patients using transfers of free vascularized fibula grafts. The purpose of this review is to critically evaluate the technique of onlay free vascularized fibula grafts for salvage of allograft complications and pathologic fractures of the long bones. This will be accomplished by reviewing the problem of allograft complications and pathologic fractures, the current treatment modalities available, the outcomes of these treatments, and future directions of treatment for this particular problem.
Friedrich
Jeffrey B
JB
Division of Plastic Surgery, University of Washington, Seattle, WA 98104-2499, USA. jfriedri@u.washington.edu
Moran
Stephen L
SL
Bishop
Allen T
AT
Shin
Alexander Y
AY
D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D005266:Femoral Neoplasms / Q000601:surgery; D005360:Fibula / Q000098:blood supply* / Q000637:transplantation*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006811:Humerus / Q000601:surgery; D016909:Tibial Arteries