Vascularised fibular grafts for reconstruction of extremity bone defects after resection of bone and soft-tissue tumours : a single institutional study of 49 patients.

Abstract

AIMS:

The aims of this study were to analyse the long-term outcome of vascularised fibular graft (VFG) reconstruction after tumour resection and to evaluate the usefulness of the method.

PATIENTS AND METHODS:

We retrospectively reviewed 49 patients who had undergone resection of a sarcoma and reconstruction using a VFG between 1988 and 2015. Their mean follow-up was 98 months (5 to 317). Reconstruction was with an osteochondral graft (n = 13), intercalary graft (n = 12), inlay graft (n = 4), or resection arthrodesis (n = 20). We analysed the oncological and functional outcome, and the rate of bony union and complications.

RESULTS:

Five- and ten-year overall survival rates were 89% and 86%, respectively. Local recurrence occurred in two patients. Eight patients developed pulmonary metastases. Bone union was achieved in 44 patients (90%). Fracture occurred in six patients (12%), infection in three (6%), and nonunion in five (10%). The mean Musculoskeletal Tumor Society (MSTS) scores were as follows: osteochondral graft 70%; intercalary graft 73%; inlay graft 89%; and resection arthrodesis 83%.

CONCLUSION:

Although associated with a relatively high rate of complications, each reconstruction method is useful, with a high rate of successful limb salvage and a good long-term functional outcome. Cite this article: Bone Joint J 2017;99-B:1237-43.

• Authors: M Emori, M Kaya, H Irifune, N Takahashi, J Shimizu, E Mizushima, Y Murahashi, T Yamashita
• Journal: The bone & joint journal (Bone Joint J) Vol. 99-B Issue 9 Pg. 1237-1243 (Sep 2017) ISSN: 2049-4408 [Electronic] England
• PMID: 28860406 (Publication Type: Journal Article)
• Copyright: ©2017 The British Editorial Society of Bone & Joint Surgery.

Topics

• Adolescent
• Adult
• Aged
• Bone Neoplasms (pathology, surgery)
• Child
• Female
• Fibula (blood supply, transplantation)
• Humans
• Leg Bones (surgery)
• Limb Salvage
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Postoperative Complications
• Plastic Surgery Procedures (methods)
• Retrospective Studies
• Sarcoma (pathology, surgery)
• Soft Tissue Neoplasms (pathology, surgery)
• Survival Rate
• Treatment Outcome