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The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects

Skeletal reconstruction after large tumor resection is challenging. The free vascularized fibular graft (FVFG) offers the potential for rapid autograft incorporation as well as growing physeal transfer in pediatric patients. We retrospectively reviewed eleven pediatric patients treated with FVFG rec...

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Detalles Bibliográficos
Autores principales: Zelenski, Nicki, Brigman, Brian E., Levin, L. Scott, Erdmann, Detlev, Eward, William C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816077/
https://www.ncbi.nlm.nih.gov/pubmed/24222724
http://dx.doi.org/10.1155/2013/321201
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author Zelenski, Nicki
Brigman, Brian E.
Levin, L. Scott
Erdmann, Detlev
Eward, William C.
author_facet Zelenski, Nicki
Brigman, Brian E.
Levin, L. Scott
Erdmann, Detlev
Eward, William C.
author_sort Zelenski, Nicki
collection PubMed
description Skeletal reconstruction after large tumor resection is challenging. The free vascularized fibular graft (FVFG) offers the potential for rapid autograft incorporation as well as growing physeal transfer in pediatric patients. We retrospectively reviewed eleven pediatric patients treated with FVFG reconstructions of the upper extremity after tumor resection. Eight male and three female patients were identified, including four who underwent epiphyseal transfer. All eleven patients retained a functional salvaged limb. Nonunion and graft fracture were the most common complications relating to graft site (27%). Peroneal nerve palsy occurred in 4/11 patients, all of whom received epiphyseal transfer. Patients receiving epiphyseal transplant had a mean annual growth of 1.7 cm/year. Mean graft hypertrophy index increased by more than 10% in all cases. Although a high complication rate may be anticipated, the free vascularized fibula may be used to reconstruct large skeletal defects in the pediatric upper extremity after oncologic resection. Transferring the vascularized physis is a viable option when longitudinal growth is desired.
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spelling pubmed-38160772013-11-11 The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects Zelenski, Nicki Brigman, Brian E. Levin, L. Scott Erdmann, Detlev Eward, William C. Sarcoma Clinical Study Skeletal reconstruction after large tumor resection is challenging. The free vascularized fibular graft (FVFG) offers the potential for rapid autograft incorporation as well as growing physeal transfer in pediatric patients. We retrospectively reviewed eleven pediatric patients treated with FVFG reconstructions of the upper extremity after tumor resection. Eight male and three female patients were identified, including four who underwent epiphyseal transfer. All eleven patients retained a functional salvaged limb. Nonunion and graft fracture were the most common complications relating to graft site (27%). Peroneal nerve palsy occurred in 4/11 patients, all of whom received epiphyseal transfer. Patients receiving epiphyseal transplant had a mean annual growth of 1.7 cm/year. Mean graft hypertrophy index increased by more than 10% in all cases. Although a high complication rate may be anticipated, the free vascularized fibula may be used to reconstruct large skeletal defects in the pediatric upper extremity after oncologic resection. Transferring the vascularized physis is a viable option when longitudinal growth is desired. Hindawi Publishing Corporation 2013 2013-10-07 /pmc/articles/PMC3816077/ /pubmed/24222724 http://dx.doi.org/10.1155/2013/321201 Text en Copyright © 2013 Nicki Zelenski et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Zelenski, Nicki
Brigman, Brian E.
Levin, L. Scott
Erdmann, Detlev
Eward, William C.
The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects
title The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects
title_full The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects
title_fullStr The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects
title_full_unstemmed The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects
title_short The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects
title_sort vascularized fibular graft in the pediatric upper extremity: a durable, biological solution to large oncologic defects
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816077/
https://www.ncbi.nlm.nih.gov/pubmed/24222724
http://dx.doi.org/10.1155/2013/321201
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