Vascularized fibular head transplantation for treatment of distal radius bone neoplasms

Abstract

Objective To evaluate the clinical outcomes of autologous vascularized fibular head transfer for repair of distal radius bone defects caused by bone tumor.Methods From June 2007 to December 2010 vascularized fibular head transfer was used in the treatment of distal radius bone defect caused by resection of benign recurrent tumors and malignant bone tumors in 6 patients.Patient ages were 17 to 53 years,with a mean of 32.5 years.Three patients had multiple tumor recurrence.After informed consent was obtained,tumor Enbolc excision was carried out.The bone defect and wrist joint surface was repaired using vascularized fibular head transfer with intemal fixation.The transplanted fibula was 11 to 16 cm in length.Results All 6 patients were follow-up for6 months to 3 years,with an average of 19 months.Primary wound healing was aclieved in all cases without infection.Healing and integration of the transplanted fibular head was observed and internal fixation removed in some patients.Mayo wrist score averaged 82,ranging from 55 to 90.By the Gartland-Werley standard score,the wrist function was rated as excellent in 1 case,good in 4 cases and fair in 1 case,with an excellent to good rate of 83.3 ％.Conclusion Vascularized fibular head transplantation used to repair distal radius bone defects after tumor resection is feasible.It has unique advantage in retaining wrist joint support by restoring the bone frame.More cases and longer follow-up are required to evaluate the long-term effects. Key words: Bone transplantation; Bone neoplasms; Radius; Caput fibula