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DOI: 10.1055/s-2004-824885
One-Bone Forearm Reconstruction Using Vascularized Fibular Graft for Massive Forearm Soft-Tissue and Bone Defect: Case Report
Publication History
Accepted: 6 January 2004
Publication Date:
19 April 2004 (online)
The authors report a case of recurrent malignant fibrous histiocytoma with extensive bone- and soft-tissue involvement, successfully treated with one-bone forearm reconstruction using a vascularized fibular graft and multiple tendon transfer. Twenty-four months after surgery, elbow and hand functions were maintained, and the patient had no disturbance of hand function in daily activity, although rotation of the forearm was sacrificed. No local recurrence or metastasis was noted. The procedure is a useful reconstructive option for complex tissue defects following wide excision of sarcoma of the forearm.
KEYWORDS
One-bone forearm reconstruction - sarcoma - vascularized fibular graft
REFERENCES
- 1 Wada T, Usui M, Isu K, Yamawakii S, Ishii S. Reconstruction and limb salvage after resection for malignant bone tumour of the proximal humerus. A sling procedure using a free vascularised fibular graft. J Bone Joint Surg Br. 1999; 81 808-813
- 2 Usui M, Murakami T, Naito T, Wada T, Takahashi T, Ishii S. Some problems in wrist reconstruction after tumor resection with vascularized fibular-head graft. J Reconstr Microsurg. 1996; 12 81-88
- 3 Hey-Groves E W. Modern Methods of Treating Fractures, 2nd ed. Bristol; John Wright & Sons, Ltd 1921
- 4 Greenwood H H. Reconstruction of forearm after loss of radius. Br J Surg. 1932; 20 58-60
- 5 Vitale C C. Reconstructive surgery for defects in the shaft of ulna in children. J Bone Joint Surg Am. 1952; 37 804-809
- 6 Murray R A. The one bone forearm. J Bone Joint Surg Am. 1955; 37 366-370
- 7 Haddad Jr R J, Drez D. Salvage procedures for defects in the forearm bones. Clin Orthop. 1974; 104 183-190
- 8 Dell P C, Sheppard J E. Vascularized bone grafts in the treatment of infected forearm nonunions. J Hand Surg Am. 1984; 9 653-658
- 9 Arai K, Toh S, Yasumura M, Okamoto Y, Harata S. One-bone forearm formation using vascularized fibula graft for massive bone defect of the forearm with infection: case report. J Reconstr Microsurg. 2001; 17 151-155
- 10 Peterson 2nd C A, Maki S, Wood M B. Clinical results of the one-bone forearm. J Hand Surg. 1995; 20A 609-618
- 11 Chen F, Culp R W, Schneider L H, Osterman A L. Revision of the ununited one-bone forearm. J Hand Surg Am. 1998; 23 1091-1096
- 12 Castle M E. One-bone forearm. J Bone Joint Surg Am. 1974; 56 1223-1227
- 13 Kitano K, Tada K. One-bone forearm procedure for partial defect of the ulna. J Pediatr Orthop. 1985; 5 290-293
- 14 Morrey B F, Askew L J, Chao E Y. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981; 63 872-877
- 15 Ogino T, Hikino K. Congenital radio-ulnar synostosis: compensatory rotation around the wrist and rotation osteotomy. J Hand Surg Br. 1987; 12 173-178
- 16 Jones N F, Swartz W M, Mears D C, Jupiter J B, Grossman A. The “double barrel” free vascularized fibular bone graft. Plast Reconstr Surg. 1988; 81 378-385
- 17 Toh S, Harata S, Ohmi Y et al.. Dual vascularized fibula transfer on a single vascular pedicle: a useful technique in long bone reconstruction. J Reconstr Microsurg. 1988; 4 217-221
Takuro WadaM.D.
Department of Orthopaedic Surgery, Sapporo Medical University
South 1, West 16
Sapporo 060-8543, Japan