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The Journal of Bone and Joint Surgery 79:583-6 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Growth of the Proximal Fibular Physis and Remodeling of the Epiphysis after Microvascular Transfer. A Case Report*

KEVIN G. SHEA, M.D.{dagger}, SHERMAN S. COLEMAN, M.D.{dagger} and DON A. COLEMAN, M.D.{dagger}, SALT LAKE CITY, UTAH

Investigation performed at the Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City


   Introduction
 
The advantages of use of vascularized grafts as compared with use of non-vascularized grafts have been demonstrated experimentally and clinically in skeletally mature individuals. These advantages include skeletal healing without creeping substitution22 of the graft from the surrounding host bone8,29; more rapid incorporation and union9; lower rates of fracture, infection, resorption, and non-union3,12,31; the option of using the grafts for the treatment of established infections8,15 and segmental defects larger than five centimeters3,8; greater initial strength8,18,25; remodeling in a manner similar to that of viable bone8,16,18,25; the ability to respond to biomechanical loading physiologically9,13,18,25; increased hypertrophy7; and a decreased duration of immobilization after implantation11.

Another, theoretical advantage of use of a microvascularized fibular graft is the potential for growth of the graft through the open physis. Continued growth of the physis after vascularized bone transfer was demonstrated by Weiland in a dog . . . [Full Text of this Article]


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