Outcomes of Free Vascularized Fibular Grafts in Treating Massive Forearm Skeletal Defects.

Autor:	Konstantinou P; 2nd Orthopaedic Department of Aristotle, University of Thessaloniki, 'G Gennimatas' Hospital, 54124 Thessaloniki, Greece.; University Hospitals Birmingham NHS Foundation Trust, Birmingham B9 5SS, UK.; Healthcare Management, School of Social Science, Hellenic Open University, 26331 Patra, Greece., Kostretzis L; 2nd Orthopaedic Department of Aristotle, University of Thessaloniki, 'G Gennimatas' Hospital, 54124 Thessaloniki, Greece., Ditsiou AZ; Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Samaras I; 2nd Orthopaedic Department of Aristotle, University of Thessaloniki, 'G Gennimatas' Hospital, 54124 Thessaloniki, Greece., Papadopoulos P; 2nd Orthopaedic Department of Aristotle, University of Thessaloniki, 'G Gennimatas' Hospital, 54124 Thessaloniki, Greece., Ditsios K; 2nd Orthopaedic Department of Aristotle, University of Thessaloniki, 'G Gennimatas' Hospital, 54124 Thessaloniki, Greece.
Jazyk:	angličtina
Zdroj:	Journal of personalized medicine [J Pers Med] 2024 Sep 14; Vol. 14 (9). Date of Electronic Publication: 2024 Sep 14.
DOI:	10.3390/jpm14090973
Abstrakt:	Introduction: Reconstructing long bone defects in the upper limbs, particularly the radius and ulna, poses significant challenges. These defects, resulting from trauma, tumors, infections, or congenital anomalies, require precise surgical intervention for functional restoration. Traditional non-vascularized autogenous bone grafts have limitations, such as resorption and limited biological activity. To address these challenges, free vascularized fibular grafts (FVFGs) have been developed, offering enhanced recovery by supplying nutrients and structural support, particularly in large defects or compromised vascularity. Materials and Methods: This retrospective study reviewed patients with significant forearm skeletal defects treated with FVFGs at our institution from January 2008 to January 2019. Included were patients with radius or ulna defects exceeding 8 cm due to trauma, tumor excision, or non-union fractures. Data on demographics, clinical details, surgical techniques, and outcomes-including graft union time, complications, range of motion, and the disabilities of the arm, shoulder and hand (DASH) scores-were analyzed. Results: Eight patients, with a mean age of 27.6 years and an average defect length of 9.8 cm, were included. All patients achieved graft union within an average of 4 months, with no tumor recurrence or significant complications. Functional outcomes showed mean forearm pronation of 56.9 degrees, supination of 52.5 degrees, and a mean DASH score of 17.7. Conclusions: FVFG is a safe and effective technique for managing complex forearm bone defects, providing high union rates and good functional outcomes. It should be considered a primary option for large forearm skeletal defects.
Databáze:	MEDLINE
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