Free Vascularized Fibular Grafts for Reconstruction of Skeletal Defects

Abstract Nourished by the peroneal vessels, the versatile free vascularized fibular graft can be transferred to reconstruct skeletal defects of the extremities. It may be combined with skin, fascia, muscle, and growth‐plate tissue to address the needs of the recipient site. It may be cut transversely and folded to reconstruct the length and width of tibial or femoral defects. The main indications for this graft are defects larger than 5 to 6 cm or with poor vascularity of the surrounding soft tissues. Detailed preoperative planning, experience in microvascular techniques, and careful postoperative follow‐up are necessary to minimize complications and improve outcome. The free vascularized fibular graft has been successfully applied as a reconstruction option in patients with traumatic or septic skeletal defect, after tumor resection, and has shown promise in patients with congenital pseudarthrosis.

[1]  J. Hermans,et al.  Reconstruction of large skeletal defects by vascularized fibula transfer , 1990, International Orthopaedics.

[2]  L. Levin,et al.  Treatment of Segmental Defects of the Humerus with an Osteoseptocutaneous Fibular Transplant , 2002, The Journal of bone and joint surgery. American volume.

[3]  R. Simonis,et al.  Management of acute and chronic osteomyelitis. , 2002, Hospital medicine.

[4]  M. Ceruso,et al.  Skeletal reconstruction with a free vascularized fibula graft associated to bone allograft after resection of malignant bone tumor of limbs. , 2001, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V....

[5]  A. Minami,et al.  Vascularised fibular grafts. An experience of 102 patients. , 2000, The Journal of bone and joint surgery. British volume.

[6]  E. Demiri,et al.  Soleus-Fibula Free Transfer in Lower Limb Reconstruction , 2000, Plastic and reconstructive surgery.

[7]  F. Wei,et al.  Outcome comparison in traumatic lower-extremity reconstruction by using various composite vascularized bone transplantation. , 1999, Plastic and reconstructive surgery.

[8]  P. Kinnunen,et al.  Congenital pseudarthrosis of the tibia. Treatment and outcome at skeletal maturity in 10 children. , 1999, Acta orthopaedica Scandinavica.

[9]  F. Sharpe,et al.  The management of bone defects of the forearm after trauma. , 1999, Hand clinics.

[10]  S. Ng,et al.  Routine donor leg angiography before vascularized free fibula transplantation is not necessary: a prospective study in 120 clinical cases. , 1999, Plastic and reconstructive surgery.

[11]  M. Innocenti,et al.  Free Vascularized Growth‐Plate Transfer after Bone Tumor Resection in Children , 1998, Journal of reconstructive microsurgery.

[12]  J. Urbaniak,et al.  Revascularization of the Femoral Head in Osteonecrosis , 1998, The Journal of the American Academy of Orthopaedic Surgeons.

[13]  L. A. Koman,et al.  The fibula-flexor hallucis longus osteomuscular flap. , 1997, The Journal of bone and joint surgery. British volume.

[14]  J. Nunley,et al.  Treatment of Segmental Defects of the Radius with Use of the Vascularized Osteoseptocutaneous Fibular Autogenous Graft* , 1997, The Journal of bone and joint surgery. American volume.

[15]  T. Vail,et al.  Donor-Site Morbidity with Use of Vascularized Autogenous Fibular Grafts* , 1996, The Journal of bone and joint surgery. American volume.

[16]  J. L. Marsh,et al.  Segmental bone deficiency after acute trauma. The role of bone transport. , 1994, The Orthopedic clinics of North America.

[17]  H. Yajima,et al.  Twin-barrelled vascularized fibular grafting to the pelvis and lower extremity. , 1994, Clinical orthopaedics and related research.

[18]  M. Beppu,et al.  Postoperative results of vascularized double fibula grafts for femoral pseudoarthrosis with large bony defect , 1994, Microsurgery.

[19]  R. Hierner,et al.  Vascularized bone transfer. , 1994, Injury.

[20]  J. Nunley,et al.  Free vascularized fibula in traumatic long bone defects and in limb salvaging following tumor resection: Comparative study , 1993, Microsurgery.

[21]  A. Weiland,et al.  Vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibia. , 1990, The Journal of bone and joint surgery. American volume.

[22]  M. Wood.  Femoral reconstruction by vascularized bone transfer , 1990, Microsurgery.

[23]  H. de Boer,et al.  Bone changes in the vascularised fibular graft. , 1989, The Journal of bone and joint surgery. British volume.

[24]  D. Mears,et al.  The "double barrel" free vascularized fibular bone graft. , 1988, Plastic and reconstructive surgery.

[25]  D. Davy,et al.  Biology of vascularized bone grafts. , 1987, The Orthopedic clinics of North America.

[26]  A. Schuurman,et al.  Laser doppler bone probe in vascularized fibula transfers: A preliminary report , 1987, Microsurgery.

[27]  M. Yoshimura,et al.  Free vascularized fibular transplant. A new method for monitoring circulation of the grafted fibula. , 1983, The Journal of bone and joint surgery. American volume.

[28]  G. I. Taylor,et al.  THE FREE VASCULARIZED BONE GRAFT: A Clinical Extension of Microvascular Techniques , 1975, Plastic and reconstructive surgery.