TY  - JOUR
T1  - Reconstruction of Large Skeletal Defects Due to Osteomyelitis with the Vascularized Fibular Graft in Children
AU  - Zalavras, Charalampos G.
AU  - Femino, Dominic
AU  - Triche, Rachel
AU  - Zionts, Lewis
AU  - Stevanovic, Milan
Y1  - 2007/10/01
N1  - 10.2106/JBJS.E.01319
JO  - The Journal of Bone & Joint Surgery
SP  - 2233
EP  - 2240
VL  - 89
IS  - 10
N2  - Background: Reconstruction of large skeletal defects secondary to
osteomyelitis is a challenging problem. The purpose of this study was to
evaluate the outcome of the use of a vascularized fibular graft to treat such
defects in children.Methods: Eight patients with a mean age of seven years and a
skeletal defect with a mean length of 11.8 cm (range, 6 to 17 cm) were treated
with a vascularized fibular graft. A staged protocol was used for the five
patients with an active infection at the time of presentation. The first
procedure consisted of radical débridement, and at the second stage a
free (seven patients) or pedicled (one patient) vascularized fibular graft was
used. The mean follow-up time was 5.7 years.Results: Union of the graft occurred primarily in seven of the eight
patients, at a mean of 3.5 months, and after iliac crest bone-grafting in the
remaining patient. There was no recurrence of deep infection. Complications
developed in two patients. The mean time to full weight-bearing by the seven
patients with a lower-extremity reconstruction was 8.4 months, and all
patients were pain-free and able to walk without supportive devices.Conclusions: A vascularized fibular graft is a viable option for the
management of large skeletal defects resulting from osteomyelitis in
children.Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.E.01319
UR  - http://dx.doi.org/10.2106/JBJS.E.01319
ER  -