title: Reconstruction of the distal ulnar epiphysis with vascularized proximal fibula including epiphysis in children after osteochondroma resection: report of two cases.
abstract: BACKGROUND
  Osteochondromas, especially multiple hereditary osteochondromas, usually cause various deformities of the joints. The authors sometimes find ulnar shortening and acquired wrist varus deformity in distal ulnar osteochondromas and even radial head dislocation resulting in ulnar shortening. In this study, the authors present the clinical outcomes of distal ulnar epiphysis reconstruction in two children using vascularized proximal fibula including the epiphysis after osteochondroma resection.
  
  
  METHODS
  The authors used vascularized proximal fibula including the epiphysis as a substitute to reconstruct the distal ulnar epiphysis after osteochondroma resection and investigated the clinical outcome in two patients (aged 4 and 9 years).
  
  
  RESULTS
  The wrist deformity was corrected successfully for both cases. Bone union between fibular grafts and hosts was found 2 months postoperatively. The reconstructed distal ulna and contralateral limbs were growing almost simultaneously. The morphology and function were also satisfactory at 1- and 8-year follow-up, respectively.
  
  
  CONCLUSIONS
  It is possible to reconstruct the distal ulna after osteochondroma resection and simultaneously keep the ulna in longitudinal growth by using vascularized proximal fibula including the epiphysis in children. However, the growth plate in the reconstructed distal ulnar epiphysis might be prematurely closed approximately 8 years after reconstruction.
  
  
  METHODS
  Therapeutic, V.
authors.affiliation: Guangzhou, People's Republic of China From the Department of Orthopedics, Guangzhou First People's Hospital, Guangzhou Medical University; and the Institute of Clinical Anatomy, Southern Medical University.
authors.forename: Yun-Fa
authors.initials: YF
authors.lastname: Yang
authors.forename: Guang-Ming
authors.initials: GM
authors.lastname: Zhang
authors.forename: Zhi-Qi
authors.initials: ZQ
authors.lastname: Huo
authors.forename: Zhong-He
authors.initials: ZH
authors.lastname: Xu
authors.forename: Da-Chuan
authors.initials: DC
authors.lastname: Xu
mesh_terms: D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004838:Epiphyses / Q000601:surgery* / Q000637:transplantation; D005260:Female; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D008297:Male; D015831:Osteochondroma / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014457:Ulna / Q000601:surgery*; D014953:Wrist / Q000601:surgery