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Reconstruction of upper limb bone Defects by Free Vascularized Fibular Graft (VFG)

Research Authors
Mohamed Mostafa Qutb
Research Journal
المؤتمر السنوى للمؤسسة الدولية لجراحة العظام (SICOT) والمنعقد فى كندا
Research Publisher
NULL
Research Rank
3
Research Vol
NULL
Research Website
NULL
Research Year
2018
Research_Pages
NULL
Research Abstract

Introduction; Upper limb bony defects is yet a debatable dilemma. Limb shortening, amputation, biological reconstruction and prothetic replacement are all options. Patients and Methods; Between 2-2003 and 1-2015, 45 cases with bone defects of the upper limb were reconstructed by free VFG at H&ULRM unit, Assiut University. Defects were > 6 cm, following trauma or tumour resection. Minimum FU was 12 months. Tumour group, 24 patients. (14 males, 10 females). Average age 19.8 years (5 to 35). The tumor involved humerus, (18), radius, (6). Post-traumatic group, 21 patients, 16 males and 5 females. The average age was 33 years (3 to 64). The average defect was 10 cm (6 to 14.5). The humerus in 7 patients, the humerus & the proximal radius and ulna in 2 patients, the humerus & the proximal ulna in 1 patient, the radius alone in 11 patients and distal radial epiphysis, carpals, and ulnar 4 metacarpals in 1 patient. Results; The graft union in group-I (tumour) was 83.3% after the primary procedure and 16.7% after a secondary procedure. In group-II (post-traumatic) was 95.2% after the primary procedure and 4.8% after a secondary procedure.The overall incidence of hypertrophy was 22.2% (10 out of 45 patients in both groups).. Conclusion; Biological reconstruction of upper limb bony defects (exceeding 6 cm), using VFG is considered a successful reconstructive way with good long lasting results.