Reconstruction of large traumatic segmental defects of the femur using segmental allograft with vascularized fibula inlay
| Autor: | Jason Bernard, Hyder Ridha, David Gateley, Martin Vesely |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Knee Joint Risk Assessment Surgical Flaps Resection Distal femur Fracture Fixation Internal Fractures Open Injury Severity Score Medicine Humans Transplantation Homologous Femur Fibula Fractures Comminuted Fibular flap Fracture Healing Wound Healing Bone Transplantation Inlay business.industry Accidents Traffic Plastic Surgery Procedures Surgery Radiography Treatment Outcome Motorcycles Tissue and Organ Harvesting Healing bone business Femoral Fractures Follow-Up Studies |
| Zdroj: | Journal of reconstructive microsurgery. 27(6) |
| ISSN: | 1098-8947 |
| Popis: | Segmental defects of the distal femur following trauma pose a reconstructive challenge. A stable reconstruction capable of withstanding high forces while allowing early mobility is paramount. The Capanna technique of reconstruction combining allograft with vascularized bone graft provides such a construct and has been described for oncological resection. We describe a modified Capanna technique, the "inlay" construct. Three reconstructions were performed for distal femoral segmental loss following trauma. One patient had bilateral reconstructions. Bone defects measuring 11, 9, and 8 cm were reconstructed using a large segmental allograft and free fibular flap inlay assembly. Both patients made uneventful recoveries and achieved full weight-bearing without walking aids 6 months postreconstruction. Range of movement of each knee joint achieved at least 90 degrees of active flexion. We have shown that large segmental traumatic defects of the femur can be successfully reconstructed using segmental allograft with vascularized fibula inlay. This reconstruction provides early mechanical stability, protecting the fibula from fracturing and allowing axial loading of healing bone. The inlay assembly allows a large area of bony contact between allograft and vascularized bone, optimizing bony healing. It is a good alternative to other established techniques of managing significant segmental defects of the distal femur. |
| Databáze: | OpenAIRE |
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