Analysis of vascularized fibula graft integration to the extracorporeal irradiated bone after reimplantation: 2-year follow-up

Luis Guilherme Rosifini Alves Rezende, Ricardo Alberto Lupinacci Penno, Edgard Eduard Engel, Nilton Mazzer


Background: Major bone segmental defects in oncologic patients continue as a therapeutic challenge to orthopedic surgeons. The few alternatives for its management and the relation between functional outcome and surgical complication remain among the main restrictions for indication of different techniques. One of these alternatives is the vascularized fibular graft in association with the creation of a bone channel made from resection of the tumor bone segment after being submitted to the extracorporeal irradiation technique. There is little subject information about long-term follow-up either prospective than retrospective studies. Aim of the study: Retrospective evaluation of vascularized fibular graft consolidation capacity from diaphysis and metaphysis and its integration to irradiated bone after transplantation. Methods: eleven patients submitted to extracorporeal irradiation technique and reimplantation with vascularized fibular graft had their radiographic images on 6, 12 and 24 months of postoperative period evaluated. Results: we observed 41.1% integration in the first year and 58.8% in the second year of follow-up, progressive in the diaphysis focus and maintenance of the metaphysis focus. Conclusion: The fibula has a good capacity for bone integration, showing less influence on the consolidation of the metaphysis portion.

Descriptors: Bone Transplantation; Osteosarcoma; Microsurgery; Surgical Oncology.


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