Reconstruction of Large Bone Defect after Wids Segmental Resection of Long Bone Tumors Using the Free Vascularized Fibular Graft

Yoo, Myung Chul; Chung, Duke Whan; Han, Jung Soo; Shin, Moon Ho

Abstract

In certain low-grade malignant tumors and tumors that have a frequent recurring tendency in long bone, the wide segmental resection can cure and prevent to recur. But a main problem is prserving of bony continuity in bony defect site due to wide segmental resection. The traditional bone graft have the high incidence in non-union, malunion, delayed union, bony reabsorption, stress fracture despite long immobilization and stiffness of adjacent joint. We have attempted to overcome these problems by using a microvascular technique to transfer the fibula with its peroneal vascular pedicle as a living bone graft. From February 1980 to August 1986, we tried the reconstruction of wide bone defect after segmental resection at long bone tumors in 10 cases, using Vascularized Fibular Graft. The types of tumors were malignant fibrous histiocytoma in 2 cases, fibrous dysplasia in 2 cases, simple bone cyst in 1 case, giant cell tumor in 2 cases, cavernous hemangioma in 2 cases and multiple exostosis in 1 case. An average follow-up was 48 months, average bone defect after wide segmental resection of lesion was 12.3cm.These all cases revealed the good bony union in average 4.5 months, the free ambulation without external immobilization was got in average 6 months. And we got the wide range of motion of adjacent joint without recurrence and serious complications.