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Published on: January 11, 2016
Comparison of limb reconstruction with vascularized fibula flap versus induced membrane technique in 54 pediatric
Louise Vandewalle1, Aurélie Mézel1, Federico Canavese1
1Jeanne de Flandre Hospital, CHU Lille, Pediatric Orthopedics Department, France.
Insights
Vascularized fibula flaps and induced membrane techniques are effective for pediatric limb reconstruction, showing comparable consolidation times and good functional outcomes in children with bone loss.
Area of Science:
- Pediatric Orthopedics
- Limb Reconstruction Surgery
- Bone Grafting Techniques
Background:
- Pediatric limb bone loss presents significant surgical challenges due to ongoing growth.
- Comparison of vascularized fibula flaps versus the induced membrane technique for pediatric bone reconstruction.
- Evaluation of bone consolidation delay and quality in growing individuals.
Purpose of the Study:
- To compare bone reconstruction outcomes in children using vascularized fibula flaps and the induced membrane technique.
- To assess the delay and quality of bone consolidation in pediatric limb reconstruction.
- To analyze complications and functional/aesthetic results of two distinct bone reconstruction methods.
Main Methods:
- Retrospective data collection from two centers for patients undergoing limb reconstruction.
- Inclusion of patients treated with either fibula flap or induced membrane technique.
- Documentation of perioperative and long-term complications, functional, and aesthetic outcomes.
Main Results:
- 31 children received fibula flaps; 13 used the induced membrane technique (Masquelet technique).
- Etiologies included tumors (76%), congenital pseudarthroses (20%), and infections (3.7%).
- Median consolidation times were 10 months (fibula flap) vs. 7.5 months (induced membrane); limb length inequality occurred in 52% (fibula) vs. 39% (induced membrane).
Conclusions:
- Both vascularized fibula flaps and the induced membrane technique are effective for reconstructing long bones in children.
- These methods provide good functional outcomes for pediatric limb reconstruction.
- Consolidation times and functional results are comparable between the fibula flap and induced membrane techniques.
Background:
Children's bone loss of limbs represents a significant challenge for surgeons, especially given that children are growing individuals. In the pediatric population, we compared bone reconstruction using vascularized fibula flaps with the induced membrane technique. The primary purpose of this study was to evaluate the delay and quality of consolidation.
Methods:
Data from patients who underwent limb reconstruction using either the fibula flap or the induced membrane were retrospectively collected from files across two centers. Perioperative and long-term complications were documented, along with functional and aesthetic outcome.
Results:
Between 2004 and 2020, 31 children underwent limb reconstruction using a fibula flap, and 13 patients were treated using the induced membrane technique. The etiologies included 76% tumors, 20% congenital pseudarthroses, and 3.7% infections. The median size of the bone resection was 12.5 cm (range: 1.8 to 31 cm). The median time to consolidation after free fibula flap transfer was 10 months (range: 2 to 55 months) versus 7.5 months (range: 1 to 64 months) for the Masquelet technique (p = 0.54). Limb length inequality occurred in 52% of fibula cases and 39% of the induced membrane cases (p = 0.55).
Conclusions:
Both of free fibula flap and the induced membrane technique are effective options for bone reconstructing long bones in children. These techniques yield good functional outcomes and have comparable consolidation times.
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