Chiba, Tokyo, and Okayama, Japan From the Division of Plastic Surgery, National Cancer Center Hospital Central and East; the Division of Orthopedic Surgery, National Cancer Center Hospital; and the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, University of Okayama.
Plast Reconstr Surg. 2011 Mar;127(3):1244-1253. doi: 10.1097/PRS.0b013e318205f34b.
Transfer of a vascularized fibular graft is the method of first choice for reconstruction of defects of long bones. In particular, the vascularized fibula head graft is preferred for patients with bone defects of the upper limb involving the distal radius or the proximal humerus. The aim of the present study was to analyze the operative results, complications, and postoperative function after vascularized fibula head graft transfer and the indications for this procedure.
From 1998 through 2008, vascularized fibula head graft transfer was performed in eight patients to reconstruct bone defects following resection of tumors of the upper limb. The primary site of the tumor was the proximal humerus in four patients and the distal radius in four patients. The postoperative course of the transferred bone was examined, and functional results were evaluated.
All vascularized fibula head grafts were transferred successfully. During the follow-up period, absorption of the transferred fibula head was not observed. The mean overall functional rating of the reconstructed shoulder joint was 70 percent. The range of motion of the reconstructed wrist joint showed no specific patterns, and instability of the wrist joint was observed in only one case.
The authors believe that the vascularized fibula head graft transfer is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius or the proximal humerus. This procedure is also useful for pediatric patients, in whom bone growth is expected after transplantation, and for salvage procedures after reconstructive materials of an artificial joint have failed.
带血管腓骨移植是重建长骨缺损的首选方法。特别是对于涉及桡骨远端或肱骨近端的上肢骨缺损患者，带血管腓骨头移植是首选。本研究旨在分析带血管腓骨头移植的手术结果、并发症和术后功能，以及该手术的适应证。
1998 年至 2008 年，我们对 8 例上肢肿瘤切除后骨缺损患者行带血管腓骨头移植。4 例患者的肿瘤原发部位在肱骨近端，4 例患者在桡骨远端。检查移植骨的术后过程，并评估功能结果。
所有带血管腓骨头移植均成功。在随访期间，未观察到移植腓骨头吸收。重建肩关节的总体功能评分平均为 70%。重建腕关节的活动范围没有特定模式，仅 1 例出现腕关节不稳定。
作者认为，带血管腓骨头移植是重建上肢的一种安全可靠的方法，特别是对于桡骨远端或肱骨近端有缺损的患者。对于预计移植后会有骨生长的儿童患者以及人工关节重建材料失败后的挽救性手术，该手术也很有用。
