Upper extremity reconstruction by vascularized bone transfers: results and complications

Area of Science:

• Orthopedic Surgery
• Microsurgery
• Reconstructive Surgery

Background:

• Upper limb reconstruction presents significant challenges.
• Vascularized fibula transfer is a reconstructive option for bone defects.

Purpose of the Study:

• To review outcomes of vascularized fibula transfer for upper limb reconstruction.
• To identify factors influencing successful bone union.

Main Methods:

• Retrospective review of 21 cases undergoing vascularized fibula transfer.
• Analysis of recipient sites including humerus, radius, ulna, and clavicle.
• Assessment of bone union rates and functional outcomes.

Main Results:

• Overall primary bone union achieved in 71.4% (15/21) and eventual union in 81% (17/21) of cases.
• 100% union rate for forearm reconstruction.
• 83% union rate for long-bone reconstruction after tumor resection.
• Two cases had stable fibrous nonunions with minimal symptoms.

Conclusions:

• Vascularized fibula transfer is an effective technique for upper limb reconstruction.
• High union rates are achievable, especially for forearm defects and post-tumor resections.
• This method provides a reliable solution for complex bone loss in the upper extremity.