Vascularized Proximal Radius Bone Graft for a Massive Elbow Bone Defect: An Anatomic Study and Case Report

Area of Science:

• Orthopedic Surgery
• Anatomy
• Vascular Surgery

Background:

• The radial artery (RA) supplies critical periosteal and osseous branches to the proximal radius.
• Reconstruction of massive osseous elbow defects presents significant surgical challenges.

Purpose of the Study:

• To anatomically delineate the proximal radial bone branches of the radial artery.
• To report the clinical application of a vascularized proximal radius bone graft (VPRBG) for elbow defect reconstruction.

Main Methods:

• Dissection of RA branches in 10 human cadaver upper limbs under loupe magnification.
• Measurement of VPRBG length and RA pedicle dimensions.
• Case study of a patient with a massive osseous elbow defect treated with VPRBG and elbow arthrodesis.

Main Results:

• The RA provides 7-14 periosteal and osseous branches to the proximal radius.
• A VPRBG up to 17 cm can be harvested with a 15 cm pedicle, offering a wide arc of rotation.
• Successful reconstruction of a 12 cm elbow defect using a 14 cm VPRBG, with no postoperative complications and good functional outcomes at 2-year follow-up.

Conclusions:

• The VPRBG is a safe and effective option for reconstructing massive osseous elbow defects when elbow arthrodesis is indicated.
• This technique, combined with the one-bone forearm method, offers a viable solution for complex elbow reconstructions.