schliessen

Filtern

 

Bibliotheken

The use of allograft shell with intramedullary vascularized fibula graft for intercalary reconstruction after diaphyseal resection for lower extremity bony malignancy

BACKGROUNDReconstruction after excision of the femur and tibia malignancy is a challenging issue for the reconstructive surgeon. The combined use of a vascularized fibular flap and allograft can provide a reliable reconstructive option. This article describes the authors' experience with this techni... Full description

Journal Title: Journal of Surgical Oncology 01 October 2010, Vol.102(5), pp.368-374
Main Author: Li, Jing
Other Authors: Wang, Zhen , Guo, Zheng , Chen, Guo‐Jing , Fu, Jun , Pei, Guo‐Xian
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0022-4790 ; E-ISSN: 1096-9098 ; DOI: 10.1002/jso.21620
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: wj10.1002/jso.21620
title: The use of allograft shell with intramedullary vascularized fibula graft for intercalary reconstruction after diaphyseal resection for lower extremity bony malignancy
format: Article
creator:
  • Li, Jing
  • Wang, Zhen
  • Guo, Zheng
  • Chen, Guo‐Jing
  • Fu, Jun
  • Pei, Guo‐Xian
subjects:
  • Vascularized Fibula
  • Allograft
  • Femur
  • Tibia
  • Tumor
ispartof: Journal of Surgical Oncology, 01 October 2010, Vol.102(5), pp.368-374
description: BACKGROUNDReconstruction after excision of the femur and tibia malignancy is a challenging issue for the reconstructive surgeon. The combined use of a vascularized fibular flap and allograft can provide a reliable reconstructive option. This article describes the authors' experience with this technique for the treatment of large-segmental bone defects after intercalary resection of lower extremity malignancy. METHODSFrom 2003 to 2008, 11 patients that had intercalary resection of lower extremity malignancy underwent reconstruction with an allograft and vascularized fibular construct. Time to union was recorded through evaluation of plain radiographs. Patients were examined clinically and radiographically and were assessed functionally with MSTS score. RESULTThe average age at time of operation was 18.5 years. The mean follow-up time was 34.1 months. The oncology result was continuous disease free in 7 patients, no evidence of disease in 2, alive with disease in 1, and died of disease in 1. Free vascularized fibula flap was used in 7 patients and ispilateral pedicle vascularized fibula in 4. The average length of the resected segment was 12.1 cm and that of the fibula flap was 16.2 cm. The primary unions were achieved in all patients except one with tibia reconstruction. The average time for bone union was 5.4 months at fibula-host junction and 11.8 months at allograft-host junction. There were no allograft fractures and no infections. Five patients had 7 local complications. The MSTS average score was 91.8% at final follow-up. The mean time of weight-bearing was 12.4 months. CONCLUSIONSIntramedullary fibular flap in combination with massive allografts provide an excellent option for reconstruction of large-bony defects after lower extremity malignancy extirpation. The viability of the fibula is a cornerstone in success of reconstruction that prevents allograft nonunion and result in decreased time to bone healing, leading to earlier patient recovery and return of function.
language: eng
source:
identifier: ISSN: 0022-4790 ; E-ISSN: 1096-9098 ; DOI: 10.1002/jso.21620
fulltext: fulltext
issn:
  • 0022-4790
  • 00224790
  • 1096-9098
  • 10969098
url: Link


@attributes
ID886657520
RANK0.07
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
LOCALfalse
PrimoNMBib
record
control
sourcerecordid10.1002/jso.21620
sourceidwj
recordidTN_wj10.1002/jso.21620
sourcesystemOther
pqid755401875
display
typearticle
titleThe use of allograft shell with intramedullary vascularized fibula graft for intercalary reconstruction after diaphyseal resection for lower extremity bony malignancy
creatorLi, Jing ; Wang, Zhen ; Guo, Zheng ; Chen, Guo‐Jing ; Fu, Jun ; Pei, Guo‐Xian
ispartofJournal of Surgical Oncology, 01 October 2010, Vol.102(5), pp.368-374
identifier
subjectVascularized Fibula ; Allograft ; Femur ; Tibia ; Tumor
languageeng
source
descriptionBACKGROUNDReconstruction after excision of the femur and tibia malignancy is a challenging issue for the reconstructive surgeon. The combined use of a vascularized fibular flap and allograft can provide a reliable reconstructive option. This article describes the authors' experience with this technique for the treatment of large-segmental bone defects after intercalary resection of lower extremity malignancy. METHODSFrom 2003 to 2008, 11 patients that had intercalary resection of lower extremity malignancy underwent reconstruction with an allograft and vascularized fibular construct. Time to union was recorded through evaluation of plain radiographs. Patients were examined clinically and radiographically and were assessed functionally with MSTS score. RESULTThe average age at time of operation was 18.5 years. The mean follow-up time was 34.1 months. The oncology result was continuous disease free in 7 patients, no evidence of disease in 2, alive with disease in 1, and died of disease in 1. Free vascularized fibula flap was used in 7 patients and ispilateral pedicle vascularized fibula in 4. The average length of the resected segment was 12.1 cm and that of the fibula flap was 16.2 cm. The primary unions were achieved in all patients except one with tibia reconstruction. The average time for bone union was 5.4 months at fibula-host junction and 11.8 months at allograft-host junction. There were no allograft fractures and no infections. Five patients had 7 local complications. The MSTS average score was 91.8% at final follow-up. The mean time of weight-bearing was 12.4 months. CONCLUSIONSIntramedullary fibular flap in combination with massive allografts provide an excellent option for reconstruction of large-bony defects after lower extremity malignancy extirpation. The viability of the fibula is a cornerstone in success of reconstruction that prevents allograft nonunion and result in decreased time to bone healing, leading to earlier patient recovery and return of function.
version4
lds50peer_reviewed
links
openurl$$Topenurl_article
openurlfulltext$$Topenurlfull_article
search
creatorcontrib
0Li, Jing
1Wang, Zhen
2Guo, Zheng
3Chen, Guo‐Jing
4Fu, Jun
5Pei, Guo‐Xian
titleThe use of allograft shell with intramedullary vascularized fibula graft for intercalary reconstruction after diaphyseal resection for lower extremity bony malignancy
subject
0Vascularized Fibula
1Allograft
2Femur
3Tibia
4Tumor
general
0English
1Wiley Subscription Services, Inc., A Wiley Company
210.1002/jso.21620
3Wiley Online Library
sourceidwj
recordidwj10.1002/jso.21620
issn
00022-4790
100224790
21096-9098
310969098
rsrctypearticle
creationdate2010
addtitle
0Journal of Surgical Oncology
1J. Surg. Oncol.
searchscope
0wj
1wiley
scope
0wj
1wiley
lsr30VSR-Enriched:[description, pqid, pages]
sort
titleThe use of allograft shell with intramedullary vascularized fibula graft for intercalary reconstruction after diaphyseal resection for lower extremity bony malignancy
authorLi, Jing ; Wang, Zhen ; Guo, Zheng ; Chen, Guo‐Jing ; Fu, Jun ; Pei, Guo‐Xian
creationdate20101001
facets
frbrgroupid6600335392122416754
frbrtype5
languageeng
creationdate2010
topic
0Vascularized Fibula
1Allograft
2Femur
3Tibia
4Tumor
collectionWiley Online Library
prefilterarticles
rsrctypearticles
creatorcontrib
0Li, Jing
1Wang, Zhen
2Guo, Zheng
3Chen, Guo‐Jing
4Fu, Jun
5Pei, Guo‐Xian
jtitleJournal of Surgical Oncology
toplevelpeer_reviewed
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
aulast
0Li
1Wang
2Guo
3Chen
4Fu
5Pei
aufirst
0Jing
1Zhen
2Zheng
3Guo‐Jing
4Jun
5Guo‐Xian
au
0Li, Jing
1Wang, Zhen
2Guo, Zheng
3Chen, Guo‐Jing
4Fu, Jun
5Pei, Guo‐Xian
atitleThe use of allograft shell with intramedullary vascularized fibula graft for intercalary reconstruction after diaphyseal resection for lower extremity bony malignancy
jtitleJournal of Surgical Oncology
risdate20101001
volume102
issue5
spage368
epage374
issn0022-4790
eissn1096-9098
genrearticle
ristypeJOUR
copHoboken
pubWiley Subscription Services, Inc., A Wiley Company
doi10.1002/jso.21620
pages368-374
date2010-10-01