title: The reconstruction of large bone defects in the upper limb.
abstract: Large bone defects in the upper limb pose many challenges in reconstructive surgery. Conventional and innovative methods have been described, employing the use of microsurgical and non-microsurgical techniques to overcome both bony and soft tissue defects. This article reviews the success and pitfalls of different techniques of reconstruction of large bone defects in the upper limb, including microsurgical transfer of the free vascularised fibula graft as a diaphyseal bone replacement and as a hemivascularised joint transplant, and non-microsurgical options using conventional bone grafting, the induced membrane technique and the role of callotatic distraction-lengthening procedures.
authors: Department of Hand & Reconstructive Microsurgery, National University Hospital, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228, Singapore.
authors: Aaron W T
authors: AW
authors: Gan
authors: Department of Hand & Reconstructive Microsurgery, National University Hospital, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228, Singapore. Electronic address: mark_e_puhaindran@nuhs.edu.sg.
authors: Mark E
authors: ME
authors: Puhaindran
authors: Department of Hand & Reconstructive Microsurgery, National University Hospital, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228, Singapore.
authors: Robert W H
authors: RW
authors: Pho
mesh_terms: D016025:Bone Transplantation; D003362:Cost-Benefit Analysis; D005360:Fibula / Q000637:transplantation*; D017102:Fracture Healing; D058752:Free Tissue Flaps / Q000098:blood supply; D006801:Humans; D006810:Humeral Fractures / Q000503:physiopathology* / Q000601:surgery; D008866:Microsurgery; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000503:physiopathology* / Q000601:surgery; D034941:Upper Extremity / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D014947:Wounds and Injuries / Q000503:physiopathology / Q000601:surgery