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Sarcoma
Volume 2013 (2013), Article ID 205832, 8 pages
http://dx.doi.org/10.1155/2013/205832
Clinical Study

Bilateral Fibular Graft: Biological Reconstruction after Resection of Primary Malignant Bone Tumors of the Lower Limb

1Centre of Orthopedic and Trauma Surgery, Department of Oncologic Surgery, Sarcoma Centre Berlin-Brandenburg, HELIOS Klinikum Berlin Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany
2Department of Vascular Surgery, Sarcoma Centre Berlin-Brandenburg, HELIOS Klinikum Berlin Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany
3Department of Pathology, Sarcoma Centre Berlin-Brandenburg, HELIOS Klinikum Emil von Behring, Walterhöferstraße 11, 14165 Berlin, Germany

Received 14 December 2012; Revised 16 February 2013; Accepted 4 March 2013

Academic Editor: Andreas Leithner

Copyright © 2013 Maya Niethard 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

This paper deals with bilateral vascularized fibular grafts (BVFG) as a method for reconstruction of metadiaphyseal defects of the femur and tibia in young patients suffering from malignant bone tumors of the lower limb. This reconstructional technique was used in 11 patients undergoing metadiaphyseal resection of lower limb malignant bone tumors. All patients with Ewing’s sarcoma and osteosarcoma had multimodal treatment according to the EURO-E.W.I.N.G 99 or COSS-96 protocol. Median FU was 63 months. None of the patients experienced local recurrence during FU. 2 patients died due to distant disease during FU. Full weight- bearing was permitted after a mean of 8 months. The median MSTS score was 87%. Complications occurred in five patients. None of the complications led to failure of the biological reconstruction or to amputation. Biological reconstruction of osseous defects is always desirable when possible and aims at a permanent solution. Good functional and durable results can be obtained by using BVFG for the reconstruction of metadiaphyseal defects of the femur and tibia. Radiotherapy in the multimodal setting increases the risk for graft or fixation failure.