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Reconstruction of extremity long bone defects with vascularized fibula bone grafts

Plastic and Aesthetic Research 2019年第6期6卷 1-12页

作者： Corinne Wee DanieI Ruter Steven SchuIz Geoffroy Sisk JuIie West Scott TintIe Ian VaIerio Division of Plastic and Reconstructive Surgery in the Department of Surgery Case Western Reserve UniversityClevelandOH 44106USA Division of Plastic and Reconstructive Surgery in the Department of Surgery Albany Medical CollegeAlbanyNY 12208USA Department of Plastic and Reconstructive Surgery The Ohio State UniversityColumbusOH 43212USA Department of Orthopaedic Surgery Walter Reed National Military Medical CenterBethesdaMD 20889USA

Aim: Composite tissue defects encompassing bone and/or isolated bony defects can pose a surgical challenge;however, their reconstruction is critical for successful functional limb salvage. These cases become increasingly problematic as secondary defects, following multiple nonvascularized grafting attempts resulting in complex bony nonunion. Herein, our experience utilizing fibula vascularized bone grafts (VBGs) for bone restoration will be presented to demonstrate their utility in a variety of reconstructions for limb salvage. Methods: This is a case series describing a series of vascularized fibula grafts for extremity reconstruction performed by a single academic surgeon over multiple institutions in seven years. Results: Twenty-seven (27) total VBGs met inclusion criteria and underwent reconstruction for traumatic (16), oncologic (6) and chronic degenerative (5) etiologies. Bony union was achieved in 26 of 27 cases. Conclusion: The decision-making process for bony reconstruction in these scenarios is difficult and multivariable. Fibula VBGs can provide a single-stage solution for autologous bony and soft tissue replacement of large or complex bone defects and can often be superior options compared with non-vascularized bone grafts or non-bone internal fixation techniques. Their osteogenic potential is unmatched by allogenic or synthetic substitutions. These benefits are evident in a variety of clinical settings such as pediatrics, oncology and trauma.

关键词： vascularized bone vascularized bone grafts composite extremity defect restoration bone reconstruction free tissue transfer microsurgery

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Treatment of Scaphoid Nonunion: Pedicled vascularized bone Graft vs. Traditional bone Graft

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2013年第5期33卷 713-716页

作者：鲍远康皓张滋洋聂铭博郭风劲 Department of Orthopedics Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

The clinical results of the application of pedicled vascularized bone graft （VBG） from Lister＇s tubercle vs. traditional bone graft （TBG） were evaluated and compared. Thirteen cases of symptomatic scaphoid nonunion were treated between January 2011 and December 2012, including 7 cases subject to VBG and the rest 6 cases to TBG, respectively. Outcomes were assessed by modified Mayo wrist score system. All cases were followed up for an average period of 3.5 months after opera- tion. The results showed that total scores in VBG group were 86.4i9.4 after operation with excellent result in 4 cases, good in 2 and acceptable in one, and those in TBG group were 71.7±9.3 after operation with good result in 2 cases, acceptable in 3 and disappointing in one. Total score of wrist function was significantly improved in VBG group as compared with TBG group （P〈0.05）. Our study suggests that VBG method is more effective for treating scaphoid nonunion than TBG method.

关键词： scaphoid nonunion Herbert screw vascularized bone grafts

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