[Reconstruction of loss of bony substance in limbs by free vascularized fibula transplant].

The authors present their experience of bone-loss reconstruction by a free vasculized fibular transfer. 62 cases were operated, with an average follow-up of 6 years (between 24 to 13 years). Studied were 15 upper limbs (10 humerus, 3 ulna, 2 radius), 28 femurs and 19 tibias. We found a male predominance: 46 cases and the average age was 33 years old. The etiology was often due to trauma: serious road traffic accidents (37 cases). 44 cases were septic and the average bone-loss was of 10 cm (between 4 cm to 30). The most frequent complications were due to fractures of the graft (10 cases) and stiffness (15 cases). Consolidation rate was of 87%: 8 were failures (3 upper limbs: 20% at femur level, 10% at tibia level). The average consolidation rate of the septic cases was of 81%, and the non-septic cases over 97.5%. It seems to be a good technique and in particular for septic cases using a basic orthopedic technique and microsurgical suture.