ABSTRACT
Clinical treatment of large segmental bone defect has always been a major challenge for the medical community,which is due to the complex and diverse pathogenic factors of large segmental bone defect.In recent years,the clinical treatment of large segmental bone defect has made great progress,and the main treatment options include vascularized or non-vascularized autologous bone grafts,allograft bone transplantation,masquelet technology,llizarov technology and bone tissue engineering.Therefore,understanding the advantages and disadvantages of various treatment options is very important for the clinical treatment of large bone defects in long bones,laying the foundation for clinical treatment.
ABSTRACT
There are several considerations in performing free vascularized fibular graft for the treatment of the large bone defect, e.g., bone fixation, additional bone graft, and management of complication. Authors have analyzed 25 cases treated with free vascularized fibular graft at Holy Family Hospital between Jun. 1985 and Dec. 1994. The mean follow up was 27.4 months The results were as follows: 1. The causes of the defect were traumatic defect with infection of 16 cases, bone tumor of 4 cases, congenital pseudoarthrosis of tibia of 3 cases and osteomyelitis of 2 cases. 2. Hypertrophy of the graft was more common in the lower extremity and in the patient under the age of 15. 3. Nonunion of graft occurred in 4 cases(16%). These cases were fixed with screws and/or pin ini tially and subsequently treated with rigid internal fixation. 4. Stress fracture of graft occurred in 3 cases(12%). Two cases of them were treated with internal fixation. 5. Additional bone graft were performed in 6 cases(24%), among 17 cases who had bone defect of lower extremity in adult. In conclusion, authors emphasize that rigid internal fixation and additional bone graft in performing free vascularized fibular graft are recommended for obtaining early solid bony union and achieving early rehabilitation.