Combined Massive Allograft and Intramedullary Vascularized Fibula as the Primary Reconstruction Method for Segmental Bone Loss in the Lower Extremity: A Systematic Review and Meta-Analysis.

JBJS Reviews
Rudolph H HoubenHenri A H Winters

Abstract

Reconstruction of segmental bone loss due to malignancy, infection, or trauma is a challenge for the reconstructive surgeon. The combination of a vascularized fibular flap with a cortical allograft provides a reliable reconstructive option in the lower extremity. In this systematic review, we describe the outcome of this technique for the treatment of segmental bone loss. A systematic review was performed on the use of a combined massive allograft and intramedullary vascularized fibula as a reconstruction method for large bone defects. We used PubMed, Embase, and the Wiley Cochrane Library. Seventeen clinical articles were included between 1997 and 2017, reporting 329 cases of lower-extremity reconstructions. A meta-analysis was performed on primary union rates. The main outcome measures were primary union rate, complication rate, reintervention rate, and function after reconstruction. All publications showed relatively high complication (5.9% to 85.7%) and reintervention rates (10% to 91.7%) with good primary union rates (66.7% to 100%) and functional outcome (range of mean Musculoskeletal Tumor Society [MSTS] scores, 24 to 29 points). The combination of a massive allograft with intramedullary vascularized fibula provides a si...Continue Reading

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Citations

May 21, 2020·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Sammy OthmanStephen J Kovach
Jun 11, 2021·Archives of Orthopaedic and Trauma Surgery·Pietro FeltriGiuseppe Filardo
Sep 4, 2021·Journal of Children's Orthopaedics·Thomas WirthEric Mascard

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