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Reconstruction of large skeletal defects by vascularized fibula transfer

Factors that influenced the outcome of union in 62 cases

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Summary

We have studied the results of reconstruction of a large skeletal defect using a vascularized fibula graft in 62 consecutive cases. We were particularly interested in factors that may significantly influence the outcome of union. In at least 90% of cases, eventual union can be expected in the reconstruction of large skeletal defects resulting from tumour resection, traumatic bone loss, or non-union. The results of reconstruction for osteomyelitis were less favorable. Statistical analysis of the influences of bone graft polarity, internal fixation, additional bone graft material, and the length of the graft on the outcome of union revealed that the use of stable fixation and additional bone graft material significantly enhanced bone union, whereas the length or polarity of the graft had no influence.

Résumé

Nous avons étudié les résultats de 62 cas consécutifs de recontruction de pertes de substances osseuses étendues, à l'aide de greffes péronières vascularisées. Nous nous sommes particulièrement intéressés aux facteurs susceptibles de retentir sur l'évolution de la consolidation. Dans au moins 90% des cas on peut compter sur une fusion osseuse lors des reconstructions osseuses pour perte de substance étendue du squelette, après résections de tumeurs, séquelles traumatiques ou pseudarthroses. Les résultats des reconstructions pour ostéite sont moins bons. L'analyse statistique de l'influence de l'orientation et de la longueur du greffon, de l'ostéosynthèse, de l'adjonction d'autre matériel osseux sur la consolidation a montré que la qualité de la fixation et l'utilisation de greffes associées favorisent la fusion, tandis que l'orientation et la longueur du greffon ne jouent aucun rôle.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, De Wever Hospital, P.O. Box 4446, C401 CX, NL-Heerlen, The Netherlands

    H. H. de Boer

  2. Department of Orthopaedics, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA

    M. B. Wood

  3. Department of Medical Statistics, University Hospital Leiden, Leiden, The Netherlands

    J. Hermans

Authors
  1. H. H. de Boer
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  2. M. B. Wood
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  3. J. Hermans
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Additional information

Read in part at the International Symposium on Bone Transplantation, Bern, Switzerland, May 15, 1987, and the Joint Meeting of the Microsurgical Society (G.A.M.) in Deauville, France, June 6, 1987

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de Boer, H.H., Wood, M.B. & Hermans, J. Reconstruction of large skeletal defects by vascularized fibula transfer. International Orthopaedics 14, 121–128 (1990). https://doi.org/10.1007/BF00180115

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