title: Free Vascularized Fibular Graft Transfer in the Reconstruction of Defects for Premalignant and Malignant Musculoskeletal Conditions of the Femur in a Tertiary Care Setting in Pakistan: A Series of Six Cases.
abstract: OBJECTIVE
  To determine the application, success and complications of the utilization of free vascularized fibular grafts (FVFG) in the reconstruction of lower limb defects after resection of primary lower limb musculoskeletal tumors.
  
  
  METHODS
  This descriptive retrospective case series analysis was conducted at Shifa International Hospital from January 2011 to January 2016. It included patients who had premalignant and malignant conditions of the lower limb and subsequently had the lesion resected followed by FVFG surgery. The data collected was to outline the demographic profile, clinical features, and post-procedure outcomes and complications.
  
  
  RESULTS
  There was a total of six patients. The mean age of the patients was 25.8 ± 11.8 years (range: 15-40 years). The patients presented with pain, swelling, inability to bear weight and/or restriction of movement at the joint. Postoperatively, one patient had proximal wound necrosis and one patient had a thrombus in the anastomosed vessels, both of which were managed successfully.
  
  
  CONCLUSIONS
  With a success rate of 100% at the end of the six-month follow-up period, FVFG surgery is a reliable procedure that may be successfully carried out for musculoskeletal tumors of the lower limb with minimal complications.
authors.affiliation: Department of Orthopaedic Surgery, Shifa College of Medicine, Islamabad, Pakistan.
authors.forename: Avais
authors.initials: A
authors.lastname: Raja
authors.affiliation: Department of Neurology, Shifa International Hospital, Islamabad, Pakistan.
authors.forename: Hana
authors.initials: H
authors.lastname: Manzoor
authors.affiliation: Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan.
authors.forename: Imad-Ud-Din
authors.initials: IU
authors.lastname: Saqib
authors.affiliation: Trauma and Orthopaedic Department, Shifa International Hospital, Islamabad, Pakistan.
authors.forename: Waqar
authors.initials: W
authors.lastname: Jan
authors.affiliation: Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan.
authors.forename: Mamoon
authors.initials: M
authors.lastname: Rashid
keywords: fvfg; musculoskeletal tumors; pakistan; tertiary setting