title: Use of vascularized free fibular head grafts for upper limb oncologic reconstruction.
abstract: BACKGROUND
  Transfer of a vascularized fibular graft is the method of first choice for reconstruction of defects of long bones. In particular, the vascularized fibula head graft is preferred for patients with bone defects of the upper limb involving the distal radius or the proximal humerus. The aim of the present study was to analyze the operative results, complications, and postoperative function after vascularized fibula head graft transfer and the indications for this procedure.
  
  
  METHODS
  From 1998 through 2008, vascularized fibula head graft transfer was performed in eight patients to reconstruct bone defects following resection of tumors of the upper limb. The primary site of the tumor was the proximal humerus in four patients and the distal radius in four patients. The postoperative course of the transferred bone was examined, and functional results were evaluated.
  
  
  RESULTS
  All vascularized fibula head grafts were transferred successfully. During the follow-up period, absorption of the transferred fibula head was not observed. The mean overall functional rating of the reconstructed shoulder joint was 70 percent. The range of motion of the reconstructed wrist joint showed no specific patterns, and instability of the wrist joint was observed in only one case.
  
  
  CONCLUSIONS
  The authors believe that the vascularized fibula head graft transfer is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius or the proximal humerus. This procedure is also useful for pediatric patients, in whom bone growth is expected after transplantation, and for salvage procedures after reconstructive materials of an artificial joint have failed.
authors.affiliation: Chiba, Tokyo, and Okayama, Japan From the Division of Plastic Surgery, National Cancer Center Hospital Central and East; the Division of Orthopedic Surgery, National Cancer Center Hospital; and the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, University of Okayama.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Onoda
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asano
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Beppu
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chuman
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Nakatani
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kimata
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus; D008297:Male; D008875:Middle Aged; D011884:Radius; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult