Simultaneous reconstruction of the bone and vessels for complex femoral defect.

Abstract

BACKGROUND:

Several methods have been reported for intercalary reconstruction of femoral defects. Of these, free vascularized fibula grafts (FVFG) are preferred because of their durability, bone-healing potential, and tolerance to infection. If the bone tumor invades the femoral vessels, simultaneous vascular reconstruction also becomes necessary and significant technical hurdles make limb salvage difficult.

CASE PRESENTATION:

We present a 10-year-old girl who underwent limb-sparing surgery for a distal femur osteosarcoma. The femoral defect was 15 cm long, and the femoral vessel defect was 10 cm long. The femur was reconstructed with bilateral FVFG, and the femoral vessels were reconstructed with saphenous vein grafts. The grafts survived without vascular compromise, and the affected limb was preserved successfully.

CONCLUSIONS:

Combined use of bilateral FVFG and autologous vein grafts makes limb-sparing surgery for a large osteosarcoma of the femur possible.

• Authors: Shimpei Miyamoto, Masahide Fujiki, Nokitaka Setsu, Akira Kawai
• Journal: World journal of surgical oncology (World J Surg Oncol) Vol. 14 Issue 1 Pg. 291 (Nov 18 2016) ISSN: 1477-7819 [Electronic] England
• PMID: 27863500 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Doxorubicin
• Cisplatin
• Methotrexate

Topics

• Antineoplastic Agents (therapeutic use)
• Autografts (blood supply)
• Bone Neoplasms (diagnostic imaging, surgery)
• Child
• Cisplatin (therapeutic use)
• Doxorubicin (therapeutic use)
• Female
• Femur (blood supply, diagnostic imaging, pathology, surgery)
• Fibula (blood supply, surgery)
• Humans
• Limb Salvage (methods)
• Magnetic Resonance Imaging
• Methotrexate (therapeutic use)
• Neoadjuvant Therapy
• Osteosarcoma (diagnostic imaging, surgery)
• Saphenous Vein (surgery)
• Surgical Flaps (blood supply)
• Transplantation, Autologous (methods)