Free vascularized fibula grafting in the operative treatment of malignant bone tumors of the upper extremity: A systematic review of outcomes and complications

2018 ◽  
Vol 117 (7) ◽  
pp. 1432-1439 ◽  
Author(s):  
Mark J. Landau ◽  
Ido Badash ◽  
Christine Yin ◽  
Ram K. Alluri ◽  
Ketan M. Patel
Keyword(s):  
Systematic Review ◽  
Upper Extremity ◽  
Operative Treatment ◽  
Bone Tumors ◽  
Malignant Bone Tumors ◽  
Vascularized Fibula

scholarly journals 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 ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Koichi Ogura ◽  
Shimpei Miyamoto ◽  
Minoru Sakuraba ◽  
Tomohiro Fujiwara ◽  
Hirokazu Chuman ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Bone Tumors ◽  
Callus Formation ◽  
Wide Resection ◽  
Rigid Fixation ◽  
Malignant Bone Tumors ◽  
Fibula Graft ◽  
Vascularized Fibula ◽  
The Mean ◽  
Vascularized Fibula Graft

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 autograft with a vascularized fibula graft and rigid fixation with a locking plate may offer better outcomes than previously reported allografts or devitalized autografts.

Vascularized fibula graft for reconstruction after resection of aggressive benign and malignant bone tumors

Microsurgery ◽  
1992 ◽  
Vol 13 (5) ◽  
pp. 227-233 ◽  
Author(s):  
Hiroshi Yajima ◽  
Susumu Tamai ◽  
Shigeru Mizumoto ◽  
Masahito Sugimura ◽  
Katsuhiro Horiuchi
Keyword(s):  
Bone Tumors ◽  
Malignant Bone Tumors ◽  
Fibula Graft ◽  
Vascularized Fibula ◽  
Vascularized Fibula Graft

scholarly journals Reconstruction of tibia by ipsilateral vascularized fibula and allograft: 12 cases with malignant bone tumors

1997 ◽  
Vol 68 (3) ◽  
pp. 298-301 ◽  
Author(s):  
Toshifumi Ozaki ◽  
Axel Hillmann ◽  
Paul Wuisman ◽  
Winfried Winkelmann
Keyword(s):  
Bone Tumors ◽  
Malignant Bone Tumors ◽  
Vascularized Fibula

scholarly journals Reconstruction of Total Bone Defects following Resection of Malignant Tumors of the Upper Extremity with 3D Printed Prostheses: Presentation of Two Patients with a Follow-Up of Three Years

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Thomas Ackmann ◽  
Sebastian Klingebiel ◽  
Georg Gosheger ◽  
Anna Rachbauer ◽  
Christoph Theil ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Bone Tumors ◽  
Malignant Tumors ◽  
Local Treatment ◽  
Tumor Resection ◽  
Bone Defects ◽  
Malignant Bone Tumors ◽  
Term Survival ◽  
First Case ◽  
3D Printed

Wide tumor resection is the local treatment of choice for patients with primary malignant bone tumors and a prerequisite for long-term survival. We present two patients that underwent total bone resection in the upper limb because of primary malignant bone tumors. The defects were then reconstructed by a 3D printed prosthesis, a procedure that, to our knowledge, has not been reported for bone defects of the upper extremity so far. Complete resection of the affected bone was required in a five-year-old girl with a high-grade osteoblastic osteosarcoma of the humerus and a 53-year-old man with a dedifferentiated leiomyosarcoma of the radius, due to the tumor’s extent. Following neoadjuvant chemotherapy, resection of the entire affected humerus including the axillary nerve took place in the first case and the entire affected radius including parts of the radial nerve in the second case. Approximately three years after surgery, both patients are alive and pain-free. Despite a postoperative drop hand that affected the now 56-year-old man, he is able to carry out everyday activities such as brushing his teeth, writing, and eating. The now eight-year-old girl is also able to engage in normal activities with her left arm such as eating and carrying lightweight objects. Both patients are tumor-free to date.

Devitalized Autograft Associated with the Vascularized Fibula Graft: Irradiation versus Freezing Methods

2021 ◽  
Author(s):  
Luis Guilherme Rosifini Alves Rezende ◽  
Guilherme Leipner Margatho ◽  
Ricardo Alberto Lupinacci Penno ◽  
Nilton Mazzer ◽  
Edgard Eduard Engel
Keyword(s):  
Retrospective Study ◽  
Local Recurrence ◽  
Bone Graft ◽  
Bone Tumors ◽  
Soft Tissues ◽  
Malignant Bone Tumors ◽  
Fibula Graft ◽  
Vascularized Fibula ◽  
Vascularized Fibula Graft ◽  
Radiographic Union

Abstract Background Among the alternatives for the management of malignant bone tumors is the “devitalized autograft associated with vascularized fibula graft.” The devitalization process is achieved by pasteurization, irradiation, or freezing. The combination of these grafts has been broadly researched for more than 25 years. However, there is no research currently published comparing the various methods or their respective outcomes. Methods A retrospective study was compiled of 26 devitalized autografts associated with vascularized fibula performed to limb salvage of malignant bone tumors. They were divided into two groups according to the devitalization method: either freezing (12 procedures) or irradiation (14 procedures). Clinical, radiographic, and scintigraphic results were assessed at least 24 months after surgery. Results The union rates reached 83.3% in the freezing group and 92.8% in the irradiated group but did not express different outcomes. Scintigraphic viability was observed in all the grafts that achieved radiographic union (Mann–Whitney U-test: p = 0.005). Three patients had nonunion, with only one having no viability in the scintigraphy (Mann–Whitney U-test: p = 0.001). There was no malignant recurrence in the autograft, only in surrounding soft tissues. Local recurrence was statistically higher in larger tumors (Mann–Whitney U-test: p = 0.025). Conclusion Both groups presented similar union rates and are considered safe to devitalize bone graft despite different outcomes observed. The survivor rates observed could be limited by the existence of the techniques.

Scintigraphy with 99m Tc-Phosphonate and 67Gallium in Patients Suspected of Primary Bone Tumors

1982 ◽  
Vol 21 (04) ◽  
pp. 136-139 ◽  
Author(s):  
C.-J. Edeling
Keyword(s):  
Soft Tissue ◽  
Bone Scintigraphy ◽  
Primary Tumor ◽  
Bone Tumors ◽  
Whole Body ◽  
Skeletal Metastases ◽  
Malignant Bone Tumors ◽  
67Ga Scintigraphy ◽  
Primary Bone Tumors ◽  
Primary Bone

Whole-body scintigraphy with both 99mTc-phosphonate and 67Ga was performed on 92 patients suspected of primary bone tumors. In 46 patients with primary malignant bone tumors, scintigraphy with 99mTc-phosphonate disclosed the primary tumor in 44 cases and skeletal metastases in 11, and 67Ga scintigraphy detected the primary tumor in 43 cases, skeletal metastases in 6 cases and soft-tissue metastases in 8 cases. In 25 patients with secondary malignant bone tumors, bone scintigraphy visualized a single lesion in 10 cases and several lesions in 15 cases, and 67Ga scintigraphy detected the primary tumor in 17 cases, skeletal metastases in 17 cases and soft-tissue metastases in 9 cases. In 21 patients with benign bone disease positive uptake of 99mTc-phosphonate was recognized in 19 cases and uptake of 67Ga in 17 cases. It is concluded that bone scintigraphy should be used in patients suspected of primary bone tumors. If malignancy is suspected, 67Ga scintigraphy should be performed in addition.

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