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A Comparison of Vascularized Free Fibular Flaps and Nonvascularized Fibular Grafts for Reconstruction of Long Bone Defects after Tumor Resection.
Estrella, Emmanuel Pantaleon; Wang, Edward H M.
Afiliación
  • Estrella EP; Microsurgery Unit, Department of Orthopedics, University of the Philippines Manila, Manila, Philippines.
  • Wang EH; UP Musculoskeletal Tumor Unit, Department of Orthopedics, University of the Philippines Manila, Manila, Philippines.
J Reconstr Microsurg ; 33(3): 194-205, 2017 Mar.
Article en En | MEDLINE | ID: mdl-27978582
Background The use of the fibula autograft has been a reliable method in the reconstruction of long bone defects after tumor resection. The objective of this study was to report the outcomes fibular grafting in terms of graft union, functional score, complications, and oncologic outcome. Methods A retrospective review of patients with fibular grafting after tumor resection was done from January 1, 1993 to December 31, 2013. The primary outcome was graft union and the revised musculoskeletal tumor society scoring system (MSTS score). The secondary outcomes were oncologic outcomes, complications, and the factors associated with graft union. Results A total of 52 patients with a mean follow-up of 42 months (SD, 33; range, 12-132 months) were included. The overall union for all fibular grafts was 37 of 52. The use of vascularized free fibula flaps had a higher union rate compared with nonvascularized fibula grafts. The use of a vascularized free fibular flap was four times likely to unite (95% CI 1.1-12.8, p = 0.039) compared with nonvascularized fibular grafts. The mean MSTS score in 36 patients was 82.5 (SD, 12.9) at 35 months from surgery (SD, 30). A total of 39 complications were present in 29 patients. On final follow-up, 45 of 52 patients were alive, six patients had died of disease and one died of other causes. Conclusion A higher union rate was achieved using vascularized free fibular flaps compared with nonvascularized fibular grafts for long bone reconstruction after tumor resection. There was no difference in terms of MSTS score between the two types of grafts.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Huesos de la Extremidad Superior / Neoplasias Óseas / Osteosarcoma / Procedimientos de Cirugía Plástica / Huesos de la Extremidad Inferior / Colgajos Tisulares Libres / Peroné Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: J Reconstr Microsurg Asunto de la revista: NEUROCIRURGIA Año: 2017 Tipo del documento: Article País de afiliación: Filipinas Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Huesos de la Extremidad Superior / Neoplasias Óseas / Osteosarcoma / Procedimientos de Cirugía Plástica / Huesos de la Extremidad Inferior / Colgajos Tisulares Libres / Peroné Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: J Reconstr Microsurg Asunto de la revista: NEUROCIRURGIA Año: 2017 Tipo del documento: Article País de afiliación: Filipinas Pais de publicación: Estados Unidos