Vascularised Fibular Graft for a Radial Defect following Tumour Excision in a Tertiary Institution in Nigeria
Options for bridging large segmental bone defects following trauma or surgical resection are numerous. Various methods have been described and tried out, each having its advantages and drawbacks. In developing countries, the choices are limited due to unavailability and high cost of sophisticated implants and materials, and the relative lack of expertise to carry out some of these procedures.
This case report highlights the use of a free vascularised fibular graft to bridge a large radial bony defect following tumour resection at a tertiary hospital in Nigeria.
Mr J. A, a 30 year old businessman, had an excision biopsy of a mass originating from his distal right radius. The histopathology report confirmed it to be a giant cell tumour. He was however left with a large (approximately 10cm) radial defect, which was subsequently bridged with a vascularised fibular graft. Post operatively, his hand and wrist functions were satisfactory.
Free vascularised fibular graft is a viable option for bridging large bone defects in developing countries. As long as the expertise is available, it is less complicated and more economical than other advanced methods. It has fewer drawbacks when compared with the methods currently in use in our environment.
Getty PJ, Peabody TD. Complications and functional outcomes of reconstruction with an osteoarticular allograft after intra-articular resection of the proximal part of the humerus. J Bone Joint Surg Am 1999;81A:1138–1146
Yuan Sun, Changqing Zhang, DongxuJin, Jiagen Sheng, Xiangguo Cheng, Xudong Liu, Shengbao Chen, and Bingfang Zeng,Free vascularised fibular grafting in the treatment of large skeletal defects due to osteomyelitis international orthopaedics, March 2010, Volume 34, Issue 3, pp 425-430
Gebert C, Hillmann A, Schwappach A, et al. Free vascularised fibular grafting for reconstruction after tumour resection in the upper extremity.J SurgOncol 2006;94:114-127
Alexander B. Dagum, MD, FRCS(C)Skeletal Reconstruction of the Upper Extremity With a Vascularised Fibula Graft: Clinical Applications, Techniques, and Results.Plastic Surgery Pulse News2011: Vol 2 Number 4
Innocenti M, Delcroix L, Manfrini M, et al. Vascularised proximal fibular epiphyseal transfer for distal radial reconstruction. J Bone Joint Surg Am 2004;86A:1504–1511.
Y. Z. Lawal, E. S. Garba1, M. O. Ogirima, I. L. Dahiru, M. I. Maitama, K. Abubakar2, F. S. Ejagwulu; Use of non-vascularized autologous fibula strut graft in the treatment of segmental bone loss, Annals of African Medicine Vol. 10, No. 1; 2011:25-8
B. Omololu, S. O. Ogunlade, T. O. Alonge; Limb conservation using non vascularised fibular grafts, West African Journal of Medicine, october-december 2002; 21:347-349
OC Nwokike, JE Onuminya, E Esezobor, E Edomwonyi, DO Olomu; Management of Bone Gaps with Intramedullary Autologous Fibular Strut Graft, Nigerian Journal of Orthopaedics and Trauma(2013), Vol 12; No 1
Collin T, Sugden P, Ahmed O, et al. Technical considerations of fibular osteocutaneous flap dissection. J PlastReconstrAesthetSurg 2008; 61:1503-1506.
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