One-bone forearm reconstruction using vascularized fibular graft for massive forearm soft-tissue and bone defect:...

Area of Science:

• Orthopedic Surgery
• Surgical Oncology
• Reconstructive Microsurgery

Background:

• Malignant fibrous histiocytoma (MFH) is a rare soft tissue sarcoma.
• Recurrent MFH with extensive bone and soft tissue involvement presents significant reconstructive challenges.
• Forearm reconstruction after wide sarcoma excision requires preserving limb function.

Observation:

• A case of recurrent MFH involving extensive bone and soft tissue of the forearm is presented.
• The patient underwent one-bone forearm reconstruction utilizing a vascularized fibular graft and tendon transfers.
• Post-operative follow-up assessed functional outcomes, including elbow and hand mobility, and checked for recurrence.

Findings:

• Successful one-bone forearm reconstruction was achieved using a vascularized fibular graft and tendon transfers.
• Excellent elbow and hand function were maintained at 24 months post-surgery.
• The patient experienced no disturbance in daily hand activities, despite sacrifice of forearm rotation.
• No local recurrence or metastasis was observed.

Implications:

• This reconstructive technique offers a useful solution for complex forearm tissue defects after sarcoma excision.
• Vascularized fibular grafting and tendon transfers can effectively restore limb function in challenging oncological cases.
• The procedure demonstrates the potential for successful limb salvage in recurrent high-grade sarcomas.