title: Near-complete Humerus Reconstruction in the Pediatric Patient with Vascularized Free Fibula Transfer.
abstract: Vascularized free fibula transfer remains the gold standard for reconstruction of large segmental diaphyseal defects of the upper extremity. In the pediatric patient, before skeletal maturity, free fibula transfer with the fibular head provides an active physis for growth and an articular interface for glenohumeral joint reconstruction. Clinical and cadaveric studies have demonstrated that the vascular supply to the fibular head originates, in most cases, from the anterior tibial system. However, anatomical variation exists, and we report a case in which a vascularized fibula autograft including the physis was transferred on the peroneal artery in a 5-year-old patient with Ewing's sarcoma. At 15-month follow-up, the patient has functional range of motion of the shoulder.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Children's National Medical Center, Washington, D.C.; and Department of Orthopedic Surgery, Medstar Cancer Institute, Washington, D.C.
authors.forename: John
authors.initials: J
authors.lastname: Shuck
authors.affiliation: Division of Plastic and Reconstructive Surgery, Children's National Medical Center, Washington, D.C.; and Department of Orthopedic Surgery, Medstar Cancer Institute, Washington, D.C.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Wood
authors.affiliation: Division of Plastic and Reconstructive Surgery, Children's National Medical Center, Washington, D.C.; and Department of Orthopedic Surgery, Medstar Cancer Institute, Washington, D.C.
authors.forename: Christopher
authors.initials: C
authors.lastname: Zarella
authors.affiliation: Division of Plastic and Reconstructive Surgery, Children's National Medical Center, Washington, D.C.; and Department of Orthopedic Surgery, Medstar Cancer Institute, Washington, D.C.
authors.forename: Albert K
authors.initials: AK
authors.lastname: Oh
authors.affiliation: Division of Plastic and Reconstructive Surgery, Children's National Medical Center, Washington, D.C.; and Department of Orthopedic Surgery, Medstar Cancer Institute, Washington, D.C.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Henshaw
authors.affiliation: Division of Plastic and Reconstructive Surgery, Children's National Medical Center, Washington, D.C.; and Department of Orthopedic Surgery, Medstar Cancer Institute, Washington, D.C.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Rogers