Arch Hand Microsurg Search

CLOSE


Arch Hand Microsurg > Volume 24(2); 2015 > Article
Archives of Hand and Microsurgery 2015;24(2):41-49.
Published online November 30, 2015.
DOI: https://doi.org/10.15596/ARMS.2015.24.2.41   
Updated Surgical Techniques and Expanded Indications of Free Vascularized Fibular Graft
Jong Woong Park*
Department of Orthopedic Surgery, Division of Hand Surgery and Reconstructive Microsurgery, Korea University Anam Hospital, Seoul, Korea. ospark@korea.ac.kr
Received: 2 November 2015   • Accepted: 19 November 2015
Abstract

Free or pedicled vascularized fibular grafts (VFG) are useful for the reconstruction of large skeletal defects, particularly in cases of scarred or avascular beds, or in patients with combined bone and soft tissue defects. Compared to non-VFG, VEG, which contains living osteocytes and osteoblasts, maintains its own viability and serves as good osteoconductive and osteoinductive graft. Due to its many structural and biological advantages, the free fibular osteo- or osteocutaneous graft is considered the most suitable autograft for the reconstruction of long bone defects in the injured extremity. The traditional indication of VFG is the long bone and soft tissue defect, which cannot be reconstructed using a conventional operative method. Recently, the indications have been widely expanded not only for defects of midtibia, humerus, forearm, distal femur, and proximal tibia, but also for the arthrodesis of shoulder and knee joints. Because of its potential to allow further bone growth, free fibular epiphyseal transfer can be used for the hip or for distal radius defects caused by the radical resection of a tumor. The basic anatomy and surgical techniques for harvesting the VFG are well known; however, the condition of the recipient site is different in each case. Therefore, careful preoperative surgical planning should be customized in every patient. In this review, recently expanded surgical indications of VFG and surgical tips based on the author’s experiences in the issues of fixation method, one or two staged reconstruction, size mismatching, overcoming the stress fracture, and arthrodesis of shoulder and knee joint using VFG are discussed with the review of literature.

Key Words: Bone defect, Soft tissue defect, Reconstruction, Free vascularized fibular graft
 


About
Article and topics
Article category

Browse all articles >

Topics

Browse all articles >

Browse articles
Editorial policies
For contributors
Editorial Office
St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93 Ji-dong, Paldal-gu, Suwon 16247, Korea
Tel: +82-31-249-7186    Fax: +82-31-254-7186    E-mail: journal@handmicro.org                

Copyright © 2024 by Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve.

Developed in M2PI

Close layer
prev next