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Free microvascular fibular versus conventional bone grafts
G Brunelli1, A Vigasio, B Battiston
1Department of Orthopaedics, Medical School, University of Brescia, Italy.
International Surgery
|January 1, 1991
Summary
Free microvascular bone grafts offer superior healing and infection resistance compared to traditional methods. This study confirms their effectiveness and reliability in diverse clinical cases, demonstrating a low failure rate.
Area of Science:
- Orthopedic Surgery
- Regenerative Medicine
- Vascularized Tissue Transfer
Background:
- Conventional bone grafts are prone to creeping substitution and slower healing.
- Free microvascular grafts possess intrinsic vascularity, promoting faster integration and infection resistance.
Purpose of the Study:
- To evaluate the efficacy and reliability of free microvascular fibular transfers.
- To compare the healing quality, reliability, and rapidity of microvascular bone transfer versus avascular grafts.
Main Methods:
- Radiographic, scintigraphic, and histologic examinations in rabbit models.
- Clinical case series of 85 free microvascular fibular transfers performed since 1975.
- Analysis of diverse orthopedic conditions including congenital defects, non-unions, osteitis, tumors, bone loss, and femoral head necrosis.
Main Results:
- Microvascular bone transfer demonstrated superior quality, reliability, and healing speed compared to avascular grafts in preclinical studies.
- The overall failure ratio in 85 clinical cases was very low.
- Six primary failures were successfully managed with conservative treatment or additional bone grafting.
Conclusions:
- Free microvascular fibular transfer is a highly effective and reliable technique for bone reconstruction.
- The inherent vascularity of these grafts significantly enhances healing and combats infection.
- This method presents a low failure rate and successful outcomes across a wide spectrum of orthopedic challenges.