Massive bone defects of the upper limb: reconstruction by vascularized bone transfer

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Bone Grafting

Background:

• Massive bone defects in the upper limb present significant reconstructive challenges.
• Infected nonunions and radionecrosis-associated nonunions require advanced treatment modalities.
• Vascularized bone transfer is an evolving technique for complex bone reconstruction.

Purpose of the Study:

• To highlight the utility and versatility of vascularized bone transfer for upper limb reconstruction.
• To discuss the indications and outcomes of this procedure in challenging clinical scenarios.
• To compare vascularized bone transfer with alternative reconstructive methods.

Main Methods:

• Review of clinical applications and outcomes of vascularized bone transfer in the upper limb.
• Analysis of cases involving massive bone defects, infected nonunions, and radionecrosis.
• Evaluation of surgical technique and patient selection criteria.

Main Results:

• Vascularized bone transfer demonstrates significant success in reconstructing large bone defects, particularly in the humerus and shoulder.
• The procedure is a valuable option for managing infected nonunions and nonunions secondary to radionecrosis.
• While technically demanding, outcomes support its consideration for major upper limb reconstructions.

Conclusions:

• Vascularized bone transfer is a highly effective and versatile technique for complex upper limb bone reconstructions.
• Its application is particularly beneficial for the humerus and shoulder, offering solutions for challenging nonunions.
• The procedure warrants consideration alongside other reconstructive options for severe bone defects.