Double-strut free vascular fibular grafting for reconstruction of the lower extremities

This article reports our experience on the treatment of long-bone defects with double-strut vascular fibular graft in 11 patients. The defects were 6-12 cm in length while 10-25 cm of vascular fibular grafts were harvested. Nine patients achieved solid union in 6 months, and two patients required additional procedures to achieve solid union. No major complications were observed, except for three patients. who had knee stiffness due to long-term immobilization and one patient who had experienced a stress fracture because of strenuous exercise at 10 months after grafting procedures. Bone union in this patient was achieved 3 months after reapplying an external fixator. It is suggested that a rigid external or internal fixator is mandatory in the course of treatment for facilitating early knee mobilization to prevent exacerbation of already compromised knee-joint motion. Vigorous exercise should be avoided for at least 12 months after solid union of the graft to prevent graft fracture. We concluded that the double-strut vascular fibular graft is an effective treatment for complicated long-bone defects of lower extremity.