The role of vascularized fibula in skeletal reconstruction

Since March 1988, 144 oncologic bone resections have been surgically treated with vascularized fibula (VF). In 30 patients VF was used after the failure of previous reconstructions, while in 114 cases (79%) VF immediately followed tumor resection. In 14 cases VF was pedicled on its vessel and used to reconstruct the ipsilateral tibia. In 17 young children, the proximal fibula was used to reconstruct with a potential growth the proximal humerus, the distal radius or the proximal femur. In 103 cases VF was combined with bone allografts. In 70 of these the fibula was inserted inside the massive allograft as a viable rod. There were 7 mechanical failures, 9 deep infections, and 10 local recurrences. According to functional evaluation, 69 patients (48%) presented with excellent functional results, 39 patients (27%) had good results while fair of poor results were recorded in 36 cases (25%).