title: Vascularized proximal fibular epiphyseal transfer for Bayne and Klug type III radial longitudinal deficiency in children.
abstract: BACKGROUND
  Treatment of Bayne and Klug type III radial longitudinal deficiency with fibular epiphyseal transplantation in children has had limited success to date. The purpose of this investigation was to review the authors' results of microvascular epiphyseal transplantation for radial longitudinal deficiency.
  
  
  METHODS
  Between 2007 and 2009, four children with a mean age of 4.3 years (range, 3.3 to 5.8 years) who had a type III radial longitudinal deficiency underwent microsurgical reconstruction of the distal radius with vascularized proximal fibular transplantation, including the physis, partial superior tibiofibular joint, and a variable length of the diaphysis. All of the grafts were supplied by the inferior lateral genicular artery. In all patients, the range of motion of the digits, wrist, forearm, and elbow; the length of the forearm; and the deviation of the wrist were evaluated.
  
  
  RESULTS
  The mean duration of follow-up was 42 months (range, 24 to 65 months). All four transfers survived and united with the host bone within 3 months postoperatively. An average correction of 28 degrees in the hand-forearm angle was obtained. Forearm length was 67.9 percent that of the normal side on average at the final follow-up. The overall range of wrist motion was approximately 55 percent that of the contralateral extremity. No major complications were observed.
  
  
  CONCLUSIONS
  Vascularized proximal fibular epiphyseal transfer, based on the inferior lateral genicular artery, is a technically feasible method for treatment of type III radial longitudinal deficiency, which maintains hand-forearm alignment, provides excellent function, and minimizes the length discrepancy between the distal radius and ulna.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Guangzhou, People's Republic of China From the Department of Microsurgery and Orthopedic Trauma, First Affiliated Hospital of Sun Yat-sen University.
authors.forename: Jiantao
authors.initials: J
authors.lastname: Yang
authors.forename: Bengang
authors.initials: B
authors.lastname: Qin
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Guo
authors.initials: G
authors.lastname: Fu
authors.forename: Jianping
authors.initials: J
authors.lastname: Xiang
authors.forename: Liqiang
authors.initials: L
authors.lastname: Gu
mesh_terms: D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000145:classification / Q000601:surgery; D004838:Epiphyses / Q000637:transplantation; D005260:Female; D005360:Fibula / Q000098:blood supply* / Q000637:transplantation*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures; D011884:Radius / Q000002:abnormalities* / Q000601:surgery*