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Sarcoma
Volume 2013 (2013), Article ID 160295, 8 pages
http://dx.doi.org/10.1155/2013/160295
Clinical Study

Intercalary Reconstructions with Vascularised Fibula and Allograft after Tumour Resection in the Lower Limb

Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria

Received 3 February 2013; Revised 9 April 2013; Accepted 28 April 2013

Academic Editor: Per-Ulf Tunn

Copyright © 2013 Katharina Rabitsch et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reconstruction with massive bone allograft and autologous vascularised fibula combines the structural strength of the allograft and the advantages of fibula’s intrinsic blood supply. We retrospectively analysed the outcome of twelve patients (4 male, 8 female) who received reconstruction with massive bone allograft and autologous vascularised fibula after tumour resection in lower limb. Mean age was 17.8 years (range 11–31 years), with following primaries: Ewing’s sarcoma ( ), osteosarcoma ( ), liposarcoma grade 2 ( ), and adamantinoma ( ). Mean followup was 38.7 months (median 25.7 months; range 2–88 months). Seven tumours were located in the femur and five in the tibia. The mean length of bone defect was 18.7 cm (range 15–25 cm). None of the grafts had to be removed, but there occurred four fractures, four nonunions, and two infections. Two patients developed donor side complication, in form of flexion deformity of the big toe. The event-free survival rate was 51% at two-year followup and 39% at three- and five-year followup. As the complications were manageable, and full weight bearing was achieved in all cases, we consider the combination of massive bone allograft and autologous vascularised fibula a stable and durable reconstruction method of the diaphysis of the lower limbs.