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Reconstruction of a 10-cm Defect in the Distal Humerus Using a Lambda-Shaped Free Vascularized Fibular Flap: A Case
Agraharam Devendra1, Asif Imran1, Hari Venkatramani2
1Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt, Coimbatore, Tamil Nadu, India.
JBJS Case Connector
|January 30, 2025
Summary
A free vascularized fibula flap effectively reconstructed a large distal humerus bone defect in a severe open fracture case. This innovative technique achieved good clinical and radiographic results for complex limb trauma.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Microsurgery
Background:
- Severe open fractures pose significant reconstruction challenges.
- Distal humerus fractures with large bone defects require advanced reconstructive techniques.
- Deep infection can complicate initial management of open fractures.
Purpose of the Study:
- To present a case of complex distal humerus reconstruction.
- To evaluate the efficacy of a Lambda-shaped free vascularized fibula flap.
- To highlight outcomes in severe open fractures with bone defects.
Main Methods:
- A 48-year-old male with Gustilo type 3A open distal humerus fracture and large bone defect.
- Initial debridement and fixation followed by management of deep infection.
- Reconstruction using a Lambda-shaped free vascularized fibula flap for both columns.
Main Results:
- Successful reconstruction of a 10-cm bone defect in the distal humerus.
- Satisfactory clinical and radiographic outcomes were achieved post-reconstruction.
- Demonstrated viability of free vascularized fibula for complex metaphyseal defects.
Conclusions:
- Lambda-shaped free vascularized fibula flap is a viable option for metaphyseal distal humerus bone defects.
- This technique provides satisfactory functional and radiological results.
- Effective management of severe open fractures with bone loss is achievable.
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