title: Vascularized proximal fibular epiphyseal transfer: two cases.
abstract: Vascularized proximal fibular epiphyseal transfer in children enables reconstruction of long-bone epiphyseal defect, while conserving axial growth potential. This technique was applied in two children for diaphyseal-epiphyseal reconstruction of the proximal humerus and distal radius respectively, using a graft vascularized only by the anterior tibial artery. There were no major complications during harvesting. Both cases showed transplant growth, of a mean 0.5cm/year. Joint function in the proximal humerus reconstruction was satisfactory, with functional range of motion. In the distal radius reconstruction, range of motion was almost zero; insufficient transplant growth induced radial club hand, requiring partial correction by progressive lengthening using an external fixator. In case of severe bone loss, fibular epiphyseal-diaphyseal graft vascularized only by the anterior tibial artery is a feasible attitude.
authors.affiliation: Children's Orthopedic Surgery Department, Brabois Children's Hospital, Nancy, France. florent1079@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Medrykowski
authors.forename: S
authors.initials: S
authors.lastname: Barbary
authors.forename: N
authors.initials: N
authors.lastname: Gibert
authors.forename: P
authors.initials: P
authors.lastname: Lascombes
authors.forename: G
authors.initials: G
authors.lastname: Dautel
mesh_terms: D001847:Bone Diseases / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002675:Child, Preschool; D004838:Epiphyses / Q000637:transplantation*; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000601:surgery*; D008297:Male; D011884:Radius / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D013997:Time Factors