Reconstruction of bone defects resulting from tumour resections by free vascularized fibular grafts

ABSTRACT

The pupose of this study was to evaluate the efficacy of free vascularized fibular grafts in reconstructing bone defects following resection of bone tumours. Twenty-five patients were studied in a prospective manner with a minimum follow up of two years. Reconstruction involved the femur and tibia in nineteen cases whereas humeral reconstructions were five and only one radial reconstruction. Union was achieved in 91.6% at an average of eight months. Complications include two stress fractures which healed conservatively and four infections of which two requied amputations. Local recurrence occurred in two cases whereas metastases occurred in five. Of the nineteen remaining patients limb survival was 89% whereas graft survival was 84%. The average functional evaluation score was 71.1% according to the system recommended by the Musculoskeletal Tumour Society. We conclude that free vascularized fibular transfer offers an efficient mode for reconstructing massive bone defects resulting from tumour resection