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Updated: Dec 22, 2025
Vascularized Composite Upper Limb Allograft Harvesting for Proximal Arm Allotransplantation
Published on: June 13, 2025
Utility of the Free Vascularized Fibula Flap to Reconstruct Oncologic Defects in the Upper Extremity
Matthew R Claxton1, Matthew B Shirley2, Karim Bakri2,3
1Mayo Clinic Medical School, Mayo Clinic, Rochester, MN, U.S.A.
Background/Aim:
Non-vascularized methods to reconstruct bone defects following tumor resection are associated with complications. As a result, the free vascularized fibular flap (FVF) has become a mainstay for reconstruction. The purpose of this study was to analyze FVF reconstruction in the upper extremity.
Patients And Methods:
We reviewed 28 (14 female and 14 male, mean age of 29±20 years) patients reconstructed with an FVF in the upper extremity following tumor resection. Reconstruction most commonly involved the humerus (n=17, 61%) and a malignant (n=23, 82%) tumor.
Results:
The limb salvage rate was 93% (n=26), with primary union occurring in 71% (n=20) of patients. Following bone grafting the overall union was 96% (n=27) at a mean 13±11 months. At most recent follow-up the mean MSTS93 rating was 82±22%.
Conclusion:
FVF effectively provided a functional reconstruction following tumor resection. Although, one in four patients will need additional bone grafting, the overall union rate is high.
