The vascularized fibular graft in the pediatric upper extremity: a durable, biological solution to large oncologic defects.

Journal Article (Journal Article)

Skeletal reconstruction after large tumor resection is challenging. The free vascularized fibular graft (FVFG) offers the potential for rapid autograft incorporation as well as growing physeal transfer in pediatric patients. We retrospectively reviewed eleven pediatric patients treated with FVFG reconstructions of the upper extremity after tumor resection. Eight male and three female patients were identified, including four who underwent epiphyseal transfer. All eleven patients retained a functional salvaged limb. Nonunion and graft fracture were the most common complications relating to graft site (27%). Peroneal nerve palsy occurred in 4/11 patients, all of whom received epiphyseal transfer. Patients receiving epiphyseal transplant had a mean annual growth of 1.7 cm/year. Mean graft hypertrophy index increased by more than 10% in all cases. Although a high complication rate may be anticipated, the free vascularized fibula may be used to reconstruct large skeletal defects in the pediatric upper extremity after oncologic resection. Transferring the vascularized physis is a viable option when longitudinal growth is desired.

Full Text

Duke Authors

Cited Authors

  • Zelenski, N; Brigman, BE; Levin, LS; Erdmann, D; Eward, WC

Published Date

  • 2013

Published In

Volume / Issue

  • 2013 /

Start / End Page

  • 321201 -

PubMed ID

  • 24222724

Pubmed Central ID

  • PMC3816077

International Standard Serial Number (ISSN)

  • 1357-714X

Digital Object Identifier (DOI)

  • 10.1155/2013/321201

Language

  • eng

Conference Location

  • Egypt