Vascularized Fibula Grafts for Reconstruction of Bone Defects after Resection of Bone Sarcomas

Abstract

We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1–24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4/3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n=2), humeral diaphysis (n=2), humeral proximal diaphysis and epiphysis (n=1), femoral diaphysis (n=1), ulnar diaphysis (n=1), and tibial diaphysis (n=1). One patient with Ewing's sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n=7) are all alive 50 months (range 26–75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n=4), pseudarthrosis (n=2), and hip dislocation (n=1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients.