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Free vascularized fibular grafts.
1Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Japan.
Journal of Reconstructive Microsurgery
|January 1, 1989
Summary
Free vascularized fibular grafts (FVFG) show promising results for bone defects and pseudarthrosis, with high bony union rates. However, outcomes vary by condition, notably lower for congenital pseudarthrosis of the tibia.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Microsurgery
Background:
- Bone defects and pseudarthrosis present significant reconstructive challenges.
- Free vascularized fibular graft (FVFG) is a reconstructive option for large bone defects.
- Evaluating the efficacy of FVFG across diverse etiologies is crucial for surgical decision-making.
Observation:
- Twenty-one patients with various bone pathologies underwent FVFG.
- Etiologies included post-traumatic defects, tumor resection, congenital pseudarthrosis, and arteriovenous fistula.
- Follow-up ranged from 15 months to 12 years (average 4.5 years).
Findings:
- Twelve patients achieved primary bony union.
- Six additional patients achieved union after secondary conventional bone grafting.
- FVFG failure occurred in three cases (non-vascularized graft), with two achieving union post-grafting; one patient required amputation.
Implications:
- FVFG demonstrates a high success rate for various bone defects, though outcomes are etiology-dependent.
- Congenital pseudarthrosis of the tibia showed lower bony union rates compared to other conditions.
- Further research into optimizing FVFG for specific challenging conditions like congenital pseudarthrosis of the tibia is warranted.