The Use of a Vascularized Fibular Autograft and Massive Allograft for Reconstruction After Intercalary Resection of the Tibia and Femur for Tumor

Abstract

Summary: The standard reconstruction after intercalary resection of tumors in the femur and tibia historically has been with a massive allograft. Although effective, this technique has been associated with a variety of complications, most commonly nonunion. This led surgeons to use a vascularized fibula in the reconstruction of these defects. In the lower weight-bearing limbs, however, fixation is difficult, and the fibula was prone to fracture. Simultaneously implanting the combination of an allograft and vascularized fibula together was developed to solve the problems of the two separate procedures. The surgical technique in both the tibia and femur is described along with a review of the outcomes and complications reported in the literature.