The Journal of Bone and Joint Surgery 79:542-50 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.
Treatment of Segmental Defects of the Radius with Use of the Vascularized Osteoseptocutaneous Fibular Autogenous Graft*
JESSE B. JUPITER, M.D. , BOSTON,
H. JOHN GERHARD, M.D. , DURHAM,
JOSÉ GUERRERO, M.D. , BOSTON, MASSACHUSETTS,
JAMES A. NUNLEY, M.D., DURHAM and
L. SCOTT LEVIN, M.D., DURHAM, NORTH CAROLINA
Investigation performed at Massachusetts General Hospital, Boston, and Duke University Medical Center, Durham
Nine patients who had a complex, combined skeletal and soft-tissue defect involving the radius were managed with operative reconstruction with use of a vascularized osteoseptocutaneous fibular autogenous graft. All of the patients were male, and the average age was thirty-two years (range, twenty-one to forty-two years). Three patients sustained the injury as the result of a gunshot wound and two each, as the result of a motor-vehicle accident, a fall from a height, or a machinery-related accident. Five patients had a concomitant fracture of the ulna. The average length of the radial defect was seven centimeters. Six patients had a deep osseous infection.
The average length of the fibular autogenous graft was 7.9 centimeters, and the average size of the associated fasciocutaneous component was 11.8 by 5.9 centimeters. Two patients had a concomitant arthrodesis of the wrist. A split-thickness skin graft was used to close the donor site in six patients. Two patients had postoperative vascular complications that necessitated revision with an autogenous vein graft. One patient had a second operation six months postoperatively to correct an angular deformity that had developed secondary to a non-union at the graft-host bone junction.
After an average duration of follow-up of twenty-four months, all but one of the patients had radiographic evidence of osseous union at both the proximal and the distal graft-host bone junction. No patient had evidence of resorption of the graft or symptoms referable to the donor leg at the time of the most recent examination. Six patients had returned to their pre-injury occupation.
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
M. L. K. Tate, T. F. Ritzman, E. Schneider, and U. R. Knothe
Testing of a New One-Stage Bone-Transport Surgical Procedure Exploiting the Periosteum for the Repair of Long-Bone Defects
J. Bone Joint Surg. Am.,
February 1, 2007;
89(2):
307 - 316.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. S. Levin
Vascularized Fibula Graft for the Traumatically Induced Long-Bone Defect
J. Am. Acad. Ortho. Surg.,
September 1, 2006;
14(10):
S175 - S176.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Ring, C. Allende, K. Jafarnia, B. T. Allende, and J. B. Jupiter
Ununited Diaphyseal Forearm Fractures with Segmental Defects: Plate Fixation and Autogenous Cancellous Bone-Grafting
J. Bone Joint Surg. Am.,
November 1, 2004;
86(11):
2440 - 2445.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. N. Malizos, C. G. Zalavras, P. N. Soucacos, A. E. Beris, and J. R. Urbaniak
Free Vascularized Fibular Grafts for Reconstruction of Skeletal Defects
J. Am. Acad. Ortho. Surg.,
September 1, 2004;
12(5):
360 - 369.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. A. DeCoster, R. J. Gehlert, E. A. Mikola, and M. A. Pirela-Cruz
Management of Posttraumatic Segmental Bone Defects
J. Am. Acad. Ortho. Surg.,
January 1, 2004;
12(1):
28 - 38.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Heitmann, D. Erdmann, and L. S. Levin
Treatment of Segmental Defects of the Humerus with an Osteoseptocutaneous Fibular Transplant
J. Bone Joint Surg. Am.,
December 9, 2002;
84(12):
2216 - 2223.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
