Abstract
Reconstruction of extremity long bone defects with vascularized fibula bone grafts
Highlights
Segmental long bone defects and bony nonunions can arise after traumatic injury, oncologic resection, or osteomyelitis
Establishing a stable bony framework is critical to successful limb salvage; bony reconstruction often presents complex challenges to the reconstructive surgeon with seemingly limited available options
Research and technology have led to a surge of products for bony reconstruction that obviate the need for autologous bone harvest, avoiding the potential donor site morbidity
Summary
Segmental long bone defects and bony nonunions can arise after traumatic injury, oncologic resection, or osteomyelitis. One must consider a variety of factors when selecting the appropriate treatment modality from a multitude of limb salvage options. Among these considerations are the surgeon’s training background and experience, location and size of defect, associated injuries, availability of soft tissue coverage, and patient comorbidities. Research and technology have led to a surge of products for bony reconstruction that obviate the need for autologous bone harvest, avoiding the potential donor site morbidity These include both allografts and synthetic products such as bone morphogenic protein (Medtronic, Minneapolis, MN), polymethylmethacrylate (Zimmer Biomet, Warsaw, IN) and tricalcium phosphate (Depuy Synthes, New Brunswick, NJ). Clinical studies suggest that both allograft and autograft can lead to adequate healing in a well-vascularized wound bed, with the end points being time to incorporation and lack of wound healing complications such as nonunion[1]
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