title: Composite vascularized fibular epiphyseo-osteo-periosteal transfer for hip reconstruction after proximal femoral tumoral resection in a 4-year-old child.
abstract: Literature on the reconstruction of the proximal femur in skeletally immature patients with the use of an epiphyseal transplant is scarce and with variable results depending on the indication. We report successful outcomes using a modified vascularized fibular epiphyseal transplant in a 4-year-old boy with an oncologic lesion. We discuss the advantages of supplementing the standard graft with a vascularized fibular periosteal tissue. The vascularized fibular epiphyseal transplant (VFET) is an effective option in the reconstruction of the epiphysis in skeletally immature patients, owing to the advantage of restoring both the joint function and the growth potential in a single surgical operation. Multiple reported cases demonstrate the effectiveness of this complex technique in upper extremity reconstruction. However, literature is scarce regarding its use for the reconstruction of the proximal femur and hip joint. Through this article, we report the use of a VFET in the reconstruction of a proximal femur in a 4-year-old boy after an intra-articular wide excision of an epithelioid hemangioendotelioma. We also discuss the advantages of designing the flap as a composite vascularized epiphyseo-osteo-periosteal flap.
authors.affiliation: Pediatric hand surgery and microsurgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Institut de Recerca (VHIR), Spain. xsoldado@gmail.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Soldado
authors.forename: Cesar Garcia
authors.initials: CG
authors.lastname: Fontecha
authors.forename: Sleiman
authors.initials: S
authors.lastname: Haddad
authors.forename: Pablo
authors.initials: P
authors.lastname: Corona
authors.forename: Diego
authors.initials: D
authors.lastname: Collado
authors.forename: Manel
authors.initials: M
authors.lastname: Llusá
authors.forename: Paulo
authors.initials: P
authors.lastname: Rego
mesh_terms: D002675:Child, Preschool; D005266:Femoral Neoplasms / Q000601:surgery*; D005270:Femur Head; D005360:Fibula / Q000637:transplantation*; D018323:Hemangioendothelioma, Epithelioid / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps