Upper limb salvage with microvascular bone transfer for major long-bone segmental tumor resections

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Oncology
• Reconstructive Surgery

Background:

• Large segmental skeletal defects in the upper extremity often result from extensive bony tumor resection.
• Reconstruction of these defects is crucial for limb salvage and functional restoration.
• Traditional methods like nonvascularized grafts or prosthetics have limitations.

Observation:

• This study presents 14 young, active patients undergoing vascularized bone graft reconstruction for large (9-15 cm) upper extremity defects.
• Defects included the proximal humerus (8), mid-humerus (2), and distal radius (4).
• Surgical techniques for distal radius and glenohumeral reconstruction using vascularized iliac crest, fibular head, and fibula are detailed.

Findings:

• Vascularized bone grafts achieved bony union in all cases.
• Patients experienced good postoperative range of motion and manageable pain levels.
• The majority of patients could resume their pre-injury activity levels.

Implications:

• Vascularized bone grafting is a highly effective reconstructive method for large upper extremity defects post-tumor resection.
• It offers superior joint function preservation, particularly for shoulder reconstructions.
• This approach represents a favorable option for upper extremity salvage compared to alternatives.