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19.04.2017 | Original Paper

Vascularized fibular medialization for reconstruction of the tibial defects following tumour excision

verfasst von: Abed El-Negery, Nabil Ahmed Elmoghazy, Mohamed Serry Abd-Ellatif, Adham Elgeidi

Erschienen in: International Orthopaedics | Ausgabe 10/2017

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Abstract

Purpose

The purpose of this study was to evaluate the functional and oncologic results of fibular medialization when used alone as a single-stage reconstructive technique after wide excision of malignant tumours of the proximal, middle, or distal tibia.

Methods

Between December 2010 and May 2015, 14 patients (six males and eight females) with primary malignant tumours of the tibia (eight proximal, four diaphyseal, two distal) were treated by wide excision. The mean age of the patients at the time of surgery was 23.2 years (11–38). The fibula was mobilized medially with its vascular pedicle to fill the defect and was fixed by a long plate and screws bypassing the graft. The average size of the defects reconstructed was 19.5 cm (18–22). Patients were evaluated functionally using the Musculoskeletal Tumour Society (MSTS) scoring system.

Results

The mean follow-up period was 31.3 months (range, 17–54). The average time for complete union was 7.6 months (range, 6–9). At final follow-up all patients had fully united grafts; 11 walked without aids. Chest metastases developed in one patient, superficial wound infection in two patients and leg length discrepancy in four patients; one case had LLD of more than 3 cm. The mean MSTS score was 23/30 points (76.5%). The minimum score was 40% (12/30) and the maximum was 90% (27/30).

Conclusions

Ipsilateral pedicled vascularized fibular centralisation or medialization is a durable reconstruction for tibial defects after wide excision of bone tumours with an acceptable functional outcome. Stable osteosynthesis is the key to union.
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Metadaten
Titel
Vascularized fibular medialization for reconstruction of the tibial defects following tumour excision
verfasst von
Abed El-Negery
Nabil Ahmed Elmoghazy
Mohamed Serry Abd-Ellatif
Adham Elgeidi
Publikationsdatum
19.04.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 10/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3474-6

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