title: Vascularized tibial periosteal graft in complex cases of bone nonunion in children.
abstract: Bone nonunion in the pediatric population usually occurs in the context of highly unfavorable biological conditions. Recently, the vascularized fibular periosteal flap has been reported as a very effective procedure for treating this condition. Even though a vascularized tibial periosteal graft (VTPG) was described long ago and has been successfully employed in one adult case, there has been no other report published on the use of this technique. We report on the use of VTPG, pedicled in the anterior tibial vessels, for the treatment of two complex pediatric bone nonunion case: a recalcitrant supracondylar femoral pseudarthrosis secondary to an infection in an 11-year-old girl, and a tibial nonunion secondary to a failed bone defect reconstruction in a 12-year-old girl. Rapid healing was obtained in both cases. In the light of the data presented, we consider VTPG as a valuable surgical option for the treatment of complex bone nonunions in children.
authors.affiliation: Department of Pediatric Upper Extremity Surgery and Microsurgery, Hospital Sant Joan de Deu, Universitat de Barcelona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Soldado
authors.forename: Jorge
authors.initials: J
authors.lastname: Knörr
authors.forename: Sleiman
authors.initials: S
authors.lastname: Haddad
authors.forename: Pablo S
authors.initials: PS
authors.lastname: Corona
authors.forename: Sergi
authors.initials: S
authors.lastname: Barrera-Ochoa
authors.forename: Diego
authors.initials: D
authors.lastname: Collado
authors.forename: Vasco V
authors.initials: VV
authors.lastname: Mascarenhas
authors.forename: Jerome Sales
authors.initials: JS
authors.lastname: de Gauzy
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D010521:Periosteum / Q000098:blood supply / Q000637:transplantation*; D013977:Tibia / Q000098:blood supply / Q000637:transplantation*; D013978:Tibial Fractures / Q000601:surgery*