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J Reconstr Microsurg 2001; 17(7): 487-496
DOI: 10.1055/s-2001-17751
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Ipsilateral Pedicle Vascularized Fibula Grafts for Reconstruction of Tibial Defects and Non-Unions

Satoshi Toh1 , Kenji Tsubo1 , Shinji Nishikawa2 , Shunsuke Narita3 , Hiromasa Kanno4 , Seiko Harata1
  • 1Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Hirosaki
  • 2Mutsu General Hospital, Mutsu, Aomori
  • 3Kuroishi Municipal Hospital, Kuroishi, Aomori
  • 4Jusendo General Hospital, Koriyama, Fukushima, Japan
Further Information

Publication History

Publication Date:
12 October 2001 (online)

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ABSTRACT

Between October 1983 and August 1998, 31 patients with non-union or bone defect of the tibia have undergone 32 vascularized fibula transfers to reconstruct lower legs. Of these 32 vascularized fibula transfers, there were 19 pedicle transfers from the ipsilateral leg. There were 17 males and two females. The average patient age was 53 (21 to 84) years old. All patients achieved good bone reconstruction. All patients are currently able to walk without a brace, except for one. As to major complications, three of these 19 had delayed union, with only one postoperative fracture. In the cases with delayed union or fractured grafted fibulas, the periods to walking without a brace were longer than in the cases without such major complications. From the results, the ipsilateral pedicle vascularized fibula graft appears to be a useful option for reconstruction of tibial defects.

KEYWORD

Ipsilateral pedicle vascularized fibula graft - lower-leg reconstruction

REFERENCES

  • 1 Chacha P B, Ahmed M, Daruwalla J S. Vascular pedicle graft of the ipsilateral fibula for non-union of the tibia with a large defect: an experimental and clinical study.  J Bone Joint Surg . 1981;  63B 244-253
    PubMedGoogle Scholar
  • 2 Chen Z W, Chen L E, Zhang G, Yu H L. Treatment of tibial defect with vascularized osteocutaneous pedicled transfer of fibula.  J Reconstr Microsurg . 1986;  2 199-203
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Chow S P, Chan K C, Tang S C, Billett D M. Reconstruction of the lateral tibial condyle by a pedicled vascularized fibular graft after en bloc resection of giant cell tumour.  Int Orthop . 1986;  10 239-243
    CrossrefPubMedGoogle Scholar
  • 4 Chung Y K, Chung S. Ipsilateral island fibula transfer for segmental tibial defects: antegrade and retrograde fashion.  Plast Reconstr Surg . 1998;  101 375-382
    PubMedGoogle Scholar
  • 5 Hertel R, Pisan M, Jakob R P. Use of the ipsilateral vascularised fibula for tibial reconstruction.  J Bone Joint Surg . 1995;  77B 914-919
    PubMedGoogle Scholar
  • 6 Minami A, Itoga H, Suzuki K. Reverse-flow vascularized fibular graft: a new method.  Microsurgery . 1990;  11 278-281
    CrossrefPubMedGoogle Scholar
  • 7 Ozaki T, Hillmann A, Wuisman P, Winkelmann W. Reconstruction of tibia by ipsilateral vascularized fibula and allograft: 12 cases with malignant bone tumors.  Acta Orthop Scand . 1997;  68 298-301
    PubMedGoogle Scholar
  • 8 Safoury Y. Use of a reversed-flow vascularized pedicle fibular graft for treatment of nonunion of the tibia.  J Reconstr Microsurg . 1999;  15 23-28
    PubMedGoogle Scholar
  • 9 Shapiro M S, Endrizzi D P, Cannon R M, Dick H M. Treatment of tibial defects and nonunions using ipsilateral vascularized fibular transposition.  Clin Orthop . 1993;  296 207-212
    PubMedGoogle Scholar
  • 10 Gerwin M, Weiland A J. Vascularized bone grafts to the upper extremity: indications and technique.  Hand Clin . 1992;  8 509-523
    PubMedGoogle Scholar
  • 11 Jones N F, Swartz W M, Mears D C. The ``double barrel'' free vascularized fibular bone graft.  Plast Reconstr Surg . 1988;  81 378-385
    CrossrefPubMedGoogle Scholar
  • 12 O'Brien B M, Gumley G J, Dooley B J, Pribaz J J. Folded free vascularized fibula transfer.  Plast Reconstr Surg . 1988;  81 311-318
    PubMedGoogle Scholar
  • 13 Toh S, Harata S, Ohmi Y. Dual vascularized fibula transfer on a single vascular pedicle: a useful technique in long bone reconstruction.  J Reconstr Microsurg . 1988;  4 217-221
    PubMedGoogle Scholar
  • 14 Paley D, Catagni M A, Argnani F. Ilizarov treatment of tibial nonunions with bone loss.  Clin Orthop . 1989;  241 146-165
    PubMedGoogle Scholar
  • 15 Aronson J. Limb-lengthening, skeletal reconstruction, and bone transport with the Ilizarov method.  J Bone Joint Surg . 1997;  79A 1243-1258
    PubMedGoogle Scholar
  • 16 Cattaneo R, Catagni M, Johnson E E. The treatment of infected nonunions and segmental defects of the tibia by the methods of Ilizarov.  Clin Orthop . 1992;  280 143-152
    PubMedGoogle Scholar
  • 17 Cierny III G, Zorn K E. Segmental tibial defects: comparing conventional and Ilizarov methodologies.  Clin Orthop . 1994;  301 118-123
    PubMedGoogle Scholar
  • 18 Green S A. Skeletal defects: a comparison of bone grafting and bone transport for segmental skeletal defects.  Clin Orthop . 1994;  301 111-117
    PubMedGoogle Scholar
  • 19 Paley D. Problems, obstacles and complications of limb lengthening by the Ilizarov technique.  Clin Orthop . 1990;  250 81-104
    PubMedGoogle Scholar
  • 20 Taylor G I, Miller G D, Ham F J. The free vascularized bone graft: a clinical extension of microvascular techniques.  Plast Reconstr Surg . 1975;  55 533-544
    Google Scholar
  • 21 Weiland A J. Vascularized bone transfers.  Instr Course Lect . 1984;  33 446-460
    Google Scholar
  • 22 Minami A, Kaneda K, Itoga H. Treatment of infected segmental defect of long bone with vascularized bone transfer.  J Reconstr Microsurg . 1992;  8 75-92
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Yajima H, Tamai S, Mizumoto S, Inada Y. Vascularized fibular grafts in the treatment of osteomyelitis and infected nonunion.  Clin Orthop . 1993;  293 256-264
    PubMedGoogle Scholar
  • 24 Minami A, Kaneda K, Itoga H, Usui M. Free vascularized fibular grafts.  J Reconstr Microsurg . 1989;  5 37-43
    PubMedGoogle Scholar
  • 25 Ihara K, Doi K, Sakai K. Fracture of free vascularized fibular grafts.  J Jpn Soc Reconstr Microsurg . 1992;  5 86-95
    PubMedGoogle Scholar
  • 26 Toh S, Tohno S, Kakizaki H. Vascularized bone grafting combined with allograft.  Seikeigeka (Jpn) . 1985;  8 181-185
    PubMedGoogle Scholar
  • 27 Vail T P, Urbaniak J R. Donor-site morbidity with use of vascularized autogenous fibular grafts J Bone Joint Surg .  1996;  78A 204-211
    PubMedGoogle Scholar
  • 28 May Jr W J, Jupiter J B, Weiland A J, Byrd H S. Clinical classification of post-traumatic tibial osteomyelitis.  J Bone Joint Surg . 1989;  71A 1422-1428
    PubMedGoogle Scholar
  • 29 Lutz B S, Wei F C, Ng S H. Routine donor leg angiography before vascularized free fibula transplantation is not necessary: a prospective study in 120 clinical cases.  Plast Reconstr Surg . 1999;  103 121-127
    CrossrefPubMedGoogle Scholar
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