The repair of long bone defects in fibrous dysplasia of lower extremities with two fibula compound transplantation inside periostem.

Abstract

Objective To study the methods of repairing bone defects in fibrous dysplasia of lower extremities with two fibula compound transplantation inside periosteum.Methods Six patients with fibrous dysplasia were treated from May 1995 to August 2003.There were 5 males and 1 female with the mean age of 25.5 years (range, 14-40 years).The tumor located at shaft of tibia in 2 patients and shaft of femur in 4 patients.Pathological diagnosis: osteofibrosis dysplasia.The length of the bone defective incomplete was 15 to 22 cm when tumor was ablated.The length of the double fibula for transplant was 17 to 24 cm, which was 2 cm more than the length of the bone defect needing to repair.The anterior-lateral fibular periosteum of the two fibulas were incised vertically, which was stripped to bone ridge.Then folded the two fibula or the two parts of fibula that the anterior-lateral fibula were contacted directly.The opposite sides of periosteum were suture to wrap the double thick fibula, and two end of the fibula were fixed, which was used to repair the bone defects.Results All 6 bone defects were healed.Bone got union after 1 year and cavitas medullaris got recanalization after 5 years.There were not tumor evidences in the transplanting double fibulas, and X-rays confirmed normal ossature.Only 1 patient's tumor relapsed in the distal segment of the normal shaft of femur, but the transplanting double fibular was not involved.The transplant bone accreted well, there was no complication of bone disunion and infection of bone.The articular genu recovered extend -flexion function.The patients could complete daily activities.Conclusion The repair of long and thick bone defects by two fibula compound transplantation inside periosteum is effective. Key words: Fibrous dysplasia of bone; Bone transplantation; Microsurgery