Intercalary reconstruction after wide resection of malignant bone tumors of the lower extremity using a composite graft with a devitalized autograft and a vascularized fibula

Sarcoma
Koichi OguraAkira Kawai

Abstract

Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autograft and a vascularized fibula graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autograft (pasteurization (n = 6), deep freezing (n = 5)) and a vascularized fibula graft composite for lower extremity malignant bone tumors (femur (n = 10), tibia (n = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autograft, 1 frozen autograft) and 1 fracture and 1 implant failure (both in pasteurized autografts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autograft, our novel method involving a combination of a frozen au...Continue Reading

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Citations

Dec 7, 2019·Cancer Metastasis Reviews·Akihiko TakeuchiHiroyuki Tsuchiya
Nov 20, 2016·World Journal of Surgical Oncology·Shimpei MiyamotoAkira Kawai
Feb 23, 2019·Clinical Orthopaedics and Related Research·Seung Yong LeeBum Suk Kim
Feb 27, 2021·Journal of Reconstructive Microsurgery·Luis Guilherme Rosifini Alves RezendeEdgard Eduard Engel

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