This Article Full Text Full Text (PDF) [Supplementary Material] Letters to the Editor: Submit a response Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Reprints and Permissions Google Scholar Articles by Friedrich, J. B. Articles by Shin, A. Y. PubMed PubMed Citation Articles by Friedrich, J. B. Articles by Shin, A. Y. Related Collections Oncology Social Bookmarking             What's this?

Free Vascularized Fibular Graft Salvage of Complications of Long-Bone Allograft After Tumor Reconstruction

¹ Division of Hand and Microvascular Surgery, Department of Orthopedic Surgery (J.B.F., S.L.M., A.T.B., and A.Y.S.) and the Division of Biostatistics, Department of Health Sciences Research (C.M.W.), Mayo Clinic, 200 First Street S.W., Rochester, MN 55905
Investigation performed at the Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Methods: A tumor registry review was conducted to identify all patients who underwent a reconstruction with a vascularized fibular graft for allograft reconstruction complications following tumor resection (host-graft nonunion, allograft fracture, or allograft nonunion) in the last nineteen years. The records of these patients were analyzed for details regarding the neoplasms and the treatment thereof, details of the free vascularized fibular graft reconstruction, time to osseous union, functional outcome, and clinical outcome.

Results: Thirty-three patients satisfied the criteria for this study. The involved bones were the femur (eighteen patients), tibia (eight), and humerus (seven). Osseous union was achieved in all patients at a mean of 7.7 months. The average duration of follow-up was seventy-three months. Twenty-three patients achieved a good or excellent functional outcome. Ultimately, seven patients had a failure of the allograft reconstruction, which resulted in limb loss in five of them. Postoperative complications were relatively common in this series.

Conclusions: Free vascularized fibular grafting is a useful adjunctive surgical treatment for nonunion, fracture, and infection of an intercalary allograft reconstruction in limb salvage surgery. It has, however, a high rate of associated complications often resulting in failure.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2008 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.