ARMS. Reconstruction of Large Femur and Tibia Defect with Free Vascularized Fibula Graft and Locking Plate INTRODUCTION.

Size: px
Start display at page:

Download "ARMS. Reconstruction of Large Femur and Tibia Defect with Free Vascularized Fibula Graft and Locking Plate INTRODUCTION."

Transcription

1 Original Article ARMS Archieves of Reconstructive Microsurgery pissn eissn Arch Reconstr Microsurg 2015;24(2): Reconstruction of Large Femur and Tibia Defect with Free Vascularized Fibula Graft and Locking Plate Min Bom Kim, Young Ho Lee*, Jeong Kook Baek, Ho Sung Choi, Goo Hyun Baek Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea Received October 29, 2015 Revised November 23, 2015 Accepted November 24, 2015 *Correspondence to: Young Ho Lee Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: Fax: Financial support: None. Conflict of interest: None. Purpose: The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported. Materials and Methods: Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates. Results: All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively. Conclusion: VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects. Key Words: Free vascularized fibula graft, Reconstruction, Locking plate, Bone defect INTRODUCTION Recent advances in multimodality treatment with chemotherapy and wide surgical resection margins have improved the prognosis of patients with musculoskeletal sarcoma. Following wide resection of the tumor, several reconstructive procedures have been applied for large bony defects, including mega-prosthesis implantation, as well as allograft and vascularized bone grafts. In view of the long-term viability of spared limbs, the limited durability of prostheses is a major problem. Because of improved long- term survival rates for sarcoma patients, a 10-year lifespan of about 50% for primary prostheses is no longer satisfactory. 1 The principal disadvantages of intercalary allografts include the high incidence of non-union (17%~50%), fracture (17%~30%) and infection (10%~15%). 2 Our group aimed to achieve biological reconstruction with living bone autografts. Free vascularized fibular graft (VFG) has become an established procedure for the treatment of massive bone defects. 3 Fibula is probably the most suitable donor bone for large defects in long bones because of its length, geometrical shape and mechanical strength. On the other hand, the femur and tibia is probably the most difficult bone for reconstruction and limb salvage remains a high-risk endeavor. The most important problem is late stress fracture of FVFG due to a low initial mechanical strength. We used locking plates to protect CC This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright 2015 by the Korean Society for Microsurgery. All Rights Reserved. 68

2 Min Bom Kim, et al. Reconstruction of Large Femur and Tibia Defect with Free Vascularized Fibula Graft and Locking Plate Table 1. Patients and reconstruction procedure Case No. Gender/age (yr) Bone defect Type of artery Length of graft Follow-up Prognosis of Diagnosis Site and gender (cm) anastomosis (cm) (yr) tumor 1 F/8 Osteosarcoma Femur 13 End-to-side 17 6 NED 2 M/14 Osteosarcoma Femur 16 End-to-side 20 5 NED 3 F/22 Osteosarcoma Femur 25 End-to-end 30 3 NED 4 M/34 Osteosarcoma Femur 10 End-to-side 15 4 NED 5 F/13 Osteosarcoma Femur 14 End-to-end 19 5 NED 6 M/35 Osteosarcoma Femur 16 End-to-side 20 3 NED 7 F/10 Osteosarcoma Femur 10 End-to-side 15 4 NED 8 M/39 Osteosarcoma Tibia 20 End-to-side 25 3 NED 9 M/24 Nonossifying fibroma Tibia 22 End-to-side 27 3 NED 10 M/63 Osteosarcoma Tibia 15 End-to-side 20 2 NED 11 F/15 Osteosarcoma Tibia 12 End-to-side 15 3 NED 12 M/25 Giant cell tumor Tibia 15 End-to-side 19 2 NED 13 F/15 Giant cell tumor Tibia 13 End-to-side 18 4 NED F: female, M: male, NED: no evidence of disease. the stress-fractured fibula graft until bone healing. To our knowledge there have been only a few studies to date describing VFG for massive bone defects of the femur following tumor resection. In the current study, a series of 13 patients treated for femur and tibia reconstruction by VFG and locking plate was reviewed retrospectively. The clinical results and complications are assessed and the hypertrophy and late stress fracture of FVFG are discussed. MATERIALS AND METHODS Patients Thirteen patients who had undergone a vascularized free fibular transfer procedure for massive femur and tibia defect secondary to extensive skeletal tumor resection were reviewed, and their characteristics are summarized in Table 1. The seven men and six women had a mean age of 30 years (8~63 years) and the mean follow-up period was 3.3 years (1~6 years). Tumor diagnoses were ten osteosarcomas, two giant cell tumors and one nonossifying fibroma. The bone defect site was from the distal third to the proximal third. All osteosarcoma patients underwent preoperative neoadjuvant chemotherapy and multiple bone reconstruction procedures, which proved to be failed (Fig. 1). Fig. 1. Radiographs of case 1 preoperatively. An 8-year-old female with an osteosarcoma of the distal femur. A 13-cm femur defect was shown. She underwent chemotherapy and multiple osteosynthesis procedures, which proved as failure. Surgical procedures Skeletal fixation of the femur and tibia was performed with a locking plate and screws ( Johnson and Johnson synthes, Paoli, PA, USA) in all patients. VFGs were transferred and placed as 69

3 Arch Reconstr Microsurg Vol. 24. No. 2. November 2015 an in-lay (intramedullar) graft and fixated with locking plate with screws to enhance the graft stability. The minimal length of bone defect was 10 cm (range 10~25 cm) and the minimal length of FVFG was 15 cm (15~30 cm). The donor peroneal artery was anastomosed to the branch of the femoral artery by the end-to-end technique in three and in four it was by the end-to-side anastomosed directly to the femoral artery. The peroneal veins were anastomosed to the vanae comitantes of the recipient artery and/or the saphenous vein by end-toend anastomosis technique (Fig. 2). In the tibia, donor artery was anastomosed to the anterior tibial artery by end-to-side technique in all 6 cases. Additional autologous bone graft from iliac bone was performed around VFG. Evaluation Graft survival was evaluated by bone scan in all cases. Bony union and hypertrophic changes of VFG and the occurrence of stress fractures were confirmed by plain radiographs obtained monthly for one year after surgery. Functional recovery was evaluated at final follow-up using the system proposed by the A B Fig. 2. Images of 17-cm free vascularized fibula graft harvested with long vein graft. The vein graft was harvested to facilitate vessel anastomosis to the recipient vessel in the deep site (A). Vessel pedicle of free vascularized fibula graft was connected to a looped vein graft. Artery and vein are identified with surgical marker to consider for the vein valves (B). Table 2. Clinical outcomes and complications Case No. Survival of graft Proximal union Distal union Follow-up (mo) MTS score Complication Graft stress fracture onset 1 Yes Graft stress fracture 6 months after VFG procedure 2 Yes Yes Yes Graft stress fracture 3 months after VFG procedure 5 Yes Yes Yes Yes Graft stress fracture 5 months after VFG procedure 9 Yes Yes Yes Yes Yes MTS: Musculoskeletal Tumor Society, VFG: vascularized fibular graft. 70

4 Min Bom Kim, et al. Reconstruction of Large Femur and Tibia Defect with Free Vascularized Fibula Graft and Locking Plate A B Fig. 3. Graft insetting images. Fibular graft was inset inlay method (A) and lateral long locking plate was applied to protect and fixed the bone defect (B). Fig. 4. The immediate postoperative X-ray images of the femur. The inlay fibula graft was fixed with locking plate. Musculoskeletal Tumor Society (MTS).8 Fig. 5. During the follow-up period, fibular graft underwent a stress fracture under the protection of lateral locking plate. Oncological outcome There was no local recurrence of malignant bone tumor and patients showed no evidence of disease at the final follow-up. RESULTS The clinical outcomes and complications per case are summarized in Table 2. Graft survival In total, all VFGs were successfully transferred (Fig. 3, 4). Vascular complications were not correlated with preoperative 71

5 Arch Reconstr Microsurg Vol. 24. No. 2. November 2015 impairment of the donor limb. DISCUSSION Fig. 6. Stress fracture of the graft showed hypertrophic bone healing and bony union between the graft and host bone was achieved within 7 months postoperatively. Fully weight bearing was permitted 10 months. chemotherapy or type of anastomosis. There were no complications from infection or wounds at either of the recipient or donor sites. Bony union All patients showed bone healing after the procedure. Late stress fractures were observed in three patients during followup period even though the weight bearing was not permitted, but stress fractures were healed eventually and made the graft hypertrophic. Fracture in the proximal junction between the recipient and graft occurred in one patient. Two fracture in the distal junction occurred as the illustrated case (Fig. 5). Although the exact time to bony union was difficult to diagnose using only plain radiographs, the proximal junctions were united by five months postoperatively at least. More than 6 months were necessary at the distal junction (Fig. 6). Functional outcome The time required for patients to walk without braces was a mean of 9 months (range 7~11 months). The MTS score was classified as good and the mean score was 81 points (range 70~85 points). No patient reported serious functional Massive femur and tibia defects resulting from bone tumors present a major challenge because of limitations with the available reconstructive methods. Although the role of VFG for difficult long bone defects has been well recognized, there are problems with long bone reconstruction. The first problem is the technically demanding nature of this procedure. The femur is located deeper than other long bones and has few main vessels suitable for microsurgical anastomosis. Monitoring of graft vascularity is troublesome because the peroneal flap used for this purpose sometimes fails to reach the skin surface. Few papers have clearly provided demonstration of graft survival. Yajima et al. 4 reported that femur reconstruction using VFG was successful in 19 out of 20 patients (95.0%), and that vascular complication of the monitoring peroneal flap occurred in 5 cases (three overstretched flaps and two thromboses). It is thought that an important factor for graft survival is not the mode of anastomosis, but rather the selection of recipient vessels. 5 Preoperative planning is easier in tumor cases compared to traumatic cases because any scar formation at the site of vascular anastomosis is usually minimal. Careful preoperative selection of recipient vessels and postoperative observation of the monitoring flap are essential. However, our cases received chemotherapy and multiple osteosynthesis procedures, which caused scar contracture and poor vessel condition because of malignant bone tumor. This makes it more difficult to transfer VFG and locking plating. The second problem with massive bone defects is the rate of bony union between VFG and long bone. Union rates of more than 80% have been reported after successful transfer. Jupiter et al. 6 were the first to report reconstruction of femur defects with FVFG. Primary bony union was achieved with single VFG in five out of seven patients with post-traumatic infection or non- union. Wood 7 reported the largest series (n=35) of femur reconstruction with VFG. Overall, 69% of patients were healed with single VFG and 83% following additional operations. These authors recommended using VFG for the reconstruction of massive femur defects greater than 10 cm. Yajima et al. 4 also demonstrated a high rate of bony union (95%) at an average time of 6.4 months after surgery. Hsu et al. 8 reported that overall 72

6 Min Bom Kim, et al. Reconstruction of Large Femur and Tibia Defect with Free Vascularized Fibula Graft and Locking Plate bony union with FVFG reconstruction was achieved in 90% of the cases after an average post-operative period of 7.6 months. The overall union rate in the current study compares favorably to other reports and supports the use of VFG with locking plate as a stable procedure for femur and tibia reconstruction. It is recommend to use long enough to cover the whole length of the long bone to prevent the stress concentration fracture at the end of the locking plate. The third problem encountered in femur and tibia reconstruction with VFG is late stress fracture. The fibula normally contributes only 1/7 to 1/10 of the total weight bearing. Its anatomic configuration, therefore, cannot be compared with the femur in terms of size or biomechanical strength. Late stress fracture is probably prevented by locking plate construct. Stress fracture causes hypertrophic changes in the VFG under the protection of locking plate. Without the locking plating, stress fractures might result in nonunion of fractured graft and graft failure. One of the major advantages of using a living fibula transfer is its ability to hypertrophy. 9 Although the causes of satisfactory hypertrophy are not completely understood, the high incidence of graft hypertrophy observed here was probably related to the mechanical stimulation provided by weight-bearing. Interestingly, the intercalary inlay graft in this series showed marked hypertrophy compared to the non- weight-bearing onlay fibula. These results demonstrate that hypertrophy of the fibula graft is associated with mechanical stimulation from weight bearing. The inlay FVFG should be placed in the correct anatomical alignment following proper fixation of the femur. In the study by Wood, 7 late stress fractures occurred in two patients and other authors have also reported a rate of approximately 10% (7%~16%) for late stress fractures of grafted fibula. 4,6 Muramatsu et al. 10 previously reported stress fracture of FVFG in cases with post- traumatic non-union of the femur. They thought that the main reason for late fracture was misalignment of FVFG of more than 15 degrees from the anatomical direction of the femur. In an attempt to minimize the risk of graft fracture, they recommended to take careful note of the following three points: double VFG, rigid internal fixation and proper alignment of inlay FVFG. However, we could draw a satisfactory result with single-barrel long VFG and locking plating. To raise the primary mechanical strength of fibula grafts, the VFG was fixed as an inlay graft within the medullary canal to support weight-bearing, while the second was locking plate that provided stable support. The locking plate provide a believable stability to the defected long bone and could function as permanent prosthesis. We aligned and stabilized the host bone with locking plate. After then, free VFG was overlapped in the host bones and linked with the locking plate using locking screws for graft protection. It was easy to achieve both the hostgraft construct stability and the procedural convenience during microsurgical vessel anastomosis of the VFG with this method. There are some reports that double-barrel VFG should be used for the bone defect of significant size mismatch situation between host and graft, but this method is double-edged sword. It could endanger the graft pedicle continuity. We assert that it is the uniqueness of our article to use the single-barrel VFG protected with locking plate. As the case illustrated, the size mismatch between the host and graft could be overcome with our method. It could be thought that VFG with locking plate is the alternative option for femur reconstruction, but we have no direct experience with alternative treatments. Tsuchiya et al. 11 used the distraction osteogenesis technique for limb salvage following skeletal tumor resection. Their results suggest that this technique may provide sufficient biomechanical strength and durability and is especially beneficial in growing children. Araki et al. 12 and Kubo et al. 13 used extra-corporeally-irradiated autograft and demonstrated good clinical results. This technique can be combined with VFG protected by locking plate to raise the mechanical strength. However, the results from our series demonstrate that VFG with locking plate is a safe procedure for femur and tibia reconstruction. Even though the stress fracture of fibula graft, locking plate protect the fracture and hypertrophic union, and the bone defects were resolved without influencing the final outcome. REFERENCES 1. Kawai A, Muschler GF, Lane JM, Otis JC, Healey JH. Prosthetic knee replacement after resection of a malignant tumor of the distal part of the femur. Medium to long-term results. J Bone Joint Surg Am 1998;80: Donati D, Di Liddo M, Zavatta M, Manfrini M, Bacci G, Picci P, et al. Massive bone allograft reconstruction in high-grade osteosarcoma. Clin Orthop Relat Res 2000;(377): Weiland AJ, Daniel RK. Microvascular anastomoses for bone grafts in the treatment of massive defects in bone. J Bone Joint 73

7 Arch Reconstr Microsurg Vol. 24. No. 2. November 2015 Surg Am 1979;61: Yajima H, Tamai S, Mizumoto S, Ono H. Vascularised fibular grafts for reconstruction of the femur. J Bone Joint Surg Br 1993; 75: Muramatsu K, Ihara K, Doi K, Shigetomi M, Hashimoto T, Taguchi T. Reconstruction of massive femur defect with free vascularized fibula graft following tumor resection. Anticancer Res 2006;26: Jupiter JB, Bour CJ, May JW Jr. The reconstruction of defects in the femoral shaft with vascularized transfers of fibular bone. J Bone Joint Surg Am 1987;69: Wood MB. Femoral reconstruction by vascularized bone transfer. Microsurgery 1990;11: Hsu RW, Wood MB, Sim FH, Chao EY. Free vascularised fibular grafting for reconstruction after tumour resection. J Bone Joint Surg Br 1997;79: de Boer HH, Wood MB. Bone changes in the vascularised fibular graft. J Bone Joint Surg Br 1989;71: Muramatsu K, Ihara K, Shigetomi M, Kawai S. Femoral reconstruction by single, folded or double free vascularised fibular grafts. Br J Plast Surg 2004;57: Tsuchiya H, Wan SL, Sakayama K, Yamamoto N, Nishida H, Tomita K. Reconstruction using an autograft containing tumour treated by liquid nitrogen. J Bone Joint Surg Br 2005;87: Araki N, Myoui A, Kuratsu S, Hashimoto N, Inoue T, Kudawara I, et al. Intraoperative extracorporeal autogenous irradiated bone grafts in tumor surgery. Clin Orthop Relat Res 1999;(368): Kubo T, Sugita T, Shimose S, Tanaka H, Nobuto H, Tanaka K, et al. Acetabular osteosarcoma treated by irradiation-vascularized hybrid bone graft. Anticancer Res. 2004;24:

Reconstruction of Massive Femur Defect with Free Vascularized Fibula Graft Following Tumor Resection

Reconstruction of Massive Femur Defect with Free Vascularized Fibula Graft Following Tumor Resection Reconstruction of Massive Femur Defect with Free Vascularized Fibula Graft Following Tumor Resection KEIICHI MURAMATSU 1, KOICHIRO IHARA 2, KAZUTERU DOI 3, MITSUNORI SHIGETOMI 1, TAKAHIRO HASHIMOTO 1 and

More information

Femoral reconstruction by single, folded or double free vascularised fibular grafts

Femoral reconstruction by single, folded or double free vascularised fibular grafts The British Association of Plastic Surgeons (2004) 57, 550 555 Femoral reconstruction by single, folded or double free vascularised fibular grafts K. Muramatsu*, K. Ihara, M. Shigetomi, S. Kawai Department

More information

Title: An intramedullary free vascularized fibular graft combined with pasteurized

Title: An intramedullary free vascularized fibular graft combined with pasteurized Title: An intramedullary free vascularized fibular graft combined with pasteurized autologous bone graft in leg reconstruction for patients with osteosarcoma Names of authors Masataka Noguchi, Hiroo Mizobuchi,

More information

Intercalary Femur and Tibia Segmental Allografts Provide an Acceptable Alternative in Reconstructing Tumor Resections

Intercalary Femur and Tibia Segmental Allografts Provide an Acceptable Alternative in Reconstructing Tumor Resections CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Number 426, pp. 97 102 2004 Lippincott Williams & Wilkins Intercalary Femur and Tibia Segmental Allografts Provide an Acceptable Alternative in Reconstructing

More information

Vascularised free fibular flap in bone resection and reconstruction *

Vascularised free fibular flap in bone resection and reconstruction * British Journal of Plastic Surgery (2005) 58, 425 430 Vascularised free fibular flap in bone resection and reconstruction * P.J. Belt*, I.C. Dickinson, D.R.B. Theile Department of Plastic and Reconstructive

More information

Treatment of non-union of forearm bones with a free vascularised cortico - periosteal flap from the medial femoral condyle

Treatment of non-union of forearm bones with a free vascularised cortico - periosteal flap from the medial femoral condyle Acta Orthop. Belg., 2009, 75, 611-615 ORIGINAL STUDY Treatment of non-union of forearm bones with a free vascularised cortico - periosteal flap from the medial femoral condyle Luc DE SMET From the University

More information

Biological Reconstruction after Excision of Juxta-articular Osteosarcoma around the Knee: A New Classification System

Biological Reconstruction after Excision of Juxta-articular Osteosarcoma around the Knee: A New Classification System Biological Reconstruction after Excision of Juxta-articular Osteosarcoma around the Knee: A New Classification System HIROYUKI TSUCHIYA 1, MOHAMED E. ABDEL-WANIS 2 and KATSURO TOMITA 1 1 Department of

More information

Reconstruction of Periacetabular Bone Tumor by Vascularized Fibula Graft and Irradiated Autograft

Reconstruction of Periacetabular Bone Tumor by Vascularized Fibula Graft and Irradiated Autograft Reconstruction of Periacetabular Bone Tumor by Vascularized Fibula Graft and Irradiated Autograft KEIICHI MURAMATSU 1, KOICHIRO IHARA 2, YASUHIRO TANI 1, RYUTA IWANAGA 1 and TOSHIHIKO TAGUCHI 1 1 Department

More information

Simultaneous reconstruction of the bone and vessels for complex femoral defect

Simultaneous reconstruction of the bone and vessels for complex femoral defect Miyamoto et al. World Journal of Surgical Oncology (2016) 14:291 DOI 10.1186/s12957-016-1037-8 CASE REPORT Open Access Simultaneous reconstruction of the bone and vessels for complex femoral defect Shimpei

More information

Fibula bone grafting in infected gap non union: A prospective case series

Fibula bone grafting in infected gap non union: A prospective case series 2019; 3(1): 06-10 ISSN (P): 2521-3466 ISSN (E): 2521-3474 Clinical Orthopaedics www.orthoresearchjournal.com 2019; 3(1): 06-10 Received: 03-11-2018 Accepted: 06-12-2018 Dr. Mohammed Nazim M.S (Ortho),

More information

Free vascularized fibular graft for tibial pseudarthrosis in neurofibromatosis

Free vascularized fibular graft for tibial pseudarthrosis in neurofibromatosis Acta Orthop Scand 1988;59(4):425-429 Free vascularized fibular graft for tibial pseudarthrosis in neurofibromatosis 03 17878 1 luli lrl Herman H. de Boer', Abraham J. Verbout', Hans K. L. Nielsen2 and

More information

Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius

Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius Chester J. Mays, BS, a Kyle Ver Steeg, MD, a Saeed Chowdhry, MD, b David Seligson,

More information

The gastrocnemius with soleus bi-muscle flap

The gastrocnemius with soleus bi-muscle flap The British Association of Plastic Surgeons (2004) 57, 77 82 The gastrocnemius with soleus bi-muscle flap Ikuo Hyodo a, *, Bin Nakayama b, Mitsuru Takahashi c, Kazuhiro Toriyama d, Yuzuru Kamei d, Shuhei

More information

Methods Used for Reconstruction in Aggressive Bone Tumours: An Early Experience

Methods Used for Reconstruction in Aggressive Bone Tumours: An Early Experience ORIGINAL ARTICLE Methods Used for Reconstruction in Aggressive Bone Tumours: An Early Experience K L Pan, FRCS*, S STing, FRCS**, A W K Mohamad, MS (Orth)*, W GLee, FRCS**, C C Wong, FRCS**, A H Rasit,

More information

The ipsilateral and contralateral fibulae have been

The ipsilateral and contralateral fibulae have been Ipsilateral vascularised fibular transport for massive defects of the tibia R. M. Atkins, P. Madhavan, J. Sudhakar, D. Whitwell From the Bristol Royal Infirmary, Bristol, England The ipsilateral and contralateral

More information

Limb Salvage Surgery for Musculoskeletal Oncology

Limb Salvage Surgery for Musculoskeletal Oncology Editorial Limb Salvage Surgery for Musculoskeletal Oncology Wan Faisham Nu man Bin Wan Ismail Submitted: 2 May 2015 Accepted: 18 June 2015 Orthopaedic Oncology Unit, Orthopaedic Department, School of Medical

More information

Clinical Study Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection

Clinical Study Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection Advances in Orthopedics Volume 2013, Article ID 397456, 5 pages http://dx.doi.org/10.1155/2013/397456 Clinical Study Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur

More information

BONE TRANSPLANTATION IN LIMB SAVING SURGERIES: THE PHILIPPINE EXPERIENCE

BONE TRANSPLANTATION IN LIMB SAVING SURGERIES: THE PHILIPPINE EXPERIENCE BONE TRANSPLANTATION IN LIMB SAVING SURGERIES: THE PHILIPPINE EXPERIENCE EDWARD HM WANG, MD UP-Musculoskeletal Tumor Unit and Tissue & Bone Bank Dept. of Orthopedics University of the Philippines-Philippine

More information

CASE REPORT. Distal radius nonunion after volar locking plate fixation of a distal radius fracture: a case report

CASE REPORT. Distal radius nonunion after volar locking plate fixation of a distal radius fracture: a case report Nagoya J. Med. Sci. 79. 551 ~ 557, 2017 doi:10.18999/nagjms.79.4.551 CASE REPORT Distal radius nonunion after volar locking plate fixation of a distal radius fracture: a case report Takaaki Shinohara 1

More information

Reconstructive treatment following resection of high-grade soft-tissue sarcomas of the lower limb

Reconstructive treatment following resection of high-grade soft-tissue sarcomas of the lower limb Journal of Orthopaedic Surgery 2005;13(1):58-63 Reconstructive treatment following resection of high-grade soft-tissue sarcomas of the lower limb AM Leow, AS Halim Reconstructive Sciences Department, Hospital

More information

Limb Salvage Surgery Using Whole Knee Joint Allograft Reconstruction in Osteosarcoma

Limb Salvage Surgery Using Whole Knee Joint Allograft Reconstruction in Osteosarcoma 244 pissn : 1226-2102, eissn : 2005-8918 Case Report J Korean Orthop Assoc 2014; 49: 244-249 http://dx.doi.org/10.4055/jkoa.2014.49.3.244 www.jkoa.org Limb Salvage Surgery Using Whole Knee Joint Allograft

More information

Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: Long-term result

Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: Long-term result Title Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: Long-term result Author(s) Ahmed, SK; Fung, BKK; Ip, WY; Chow, SP Citation Strategies In Trauma And Limb Reconstruction,

More information

Laura M. Fayad, MD. Associate Professor of Radiology, Orthopaedic Surgery & Oncology The Johns Hopkins University

Laura M. Fayad, MD. Associate Professor of Radiology, Orthopaedic Surgery & Oncology The Johns Hopkins University Society of Pediatric Radiology, May 2013 Laura M. Fayad, MD Associate Professor of Radiology, Orthopaedic Surgery & Oncology The Johns Hopkins University Describes surgical techniques that resect and reconstruct

More information

Correction of Long Standing Proximal Interphalangeal Flexion Contractures with Cross Finger Flaps and Vigorous Postoperative Exercises

Correction of Long Standing Proximal Interphalangeal Flexion Contractures with Cross Finger Flaps and Vigorous Postoperative Exercises Original Article DOI 10.3349/ymj.2010.51.4.574 pissn: 0513-5796, eissn: 1976-2437 Yonsei Med J 51(4):574-578, 2010 Correction of Long Standing Proximal Interphalangeal Flexion Contractures with Cross Finger

More information

What Is the Outcome of Allograft and Intramedullary Free Fibula (Capanna Technique) in Pediatric and Adolescent Patients With Bone Tumors?

What Is the Outcome of Allograft and Intramedullary Free Fibula (Capanna Technique) in Pediatric and Adolescent Patients With Bone Tumors? Clin Orthop Relat Res (2016) 474:660 668 DOI 10.1007/s11999-015-4204-2 Clinical Orthopaedics and Related Research A Publication of The Association of Bone and Joint Surgeons SYMPOSIUM: 2014 MUSCULOSKELETAL

More information

Treatment of Periprosthetic Femoral Fractures Following Hip Arthroplasty

Treatment of Periprosthetic Femoral Fractures Following Hip Arthroplasty ORIGINAL ARTICLE Hip Pelvis 30(2): 78-85, 2018 http://dx.doi.org/10.5371/hp.2018.30.2.78 Print ISSN 2287-3260 Online ISSN 2287-3279 Treatment of Periprosthetic Femoral Fractures Following Hip Arthroplasty

More information

Vascularized Bone Graft for Oncological Reconstruction of the Extremities: Review of the Biological Advantages

Vascularized Bone Graft for Oncological Reconstruction of the Extremities: Review of the Biological Advantages Review Vascularized Bone Graft for Oncological Reconstruction of the Extremities: Review of the Biological Advantages KEIICHI MURAMATSU, TAKAHIRO HASHIMOTO, YASUHIRO TOMINAGA and TOSHIHIKO TAGUCHI Department

More information

The Journal of the Korean Society of Fractures Vol.13, No.3, July, 2000

The Journal of the Korean Society of Fractures Vol.13, No.3, July, 2000 The Journal of the Korean Society of Fractures Vol13, No3, July, 2000 2, 3 ) : 40-12, Tel : (02) 966-1616 Fax : (02) 968-2394 E-mail : adkajs@thrunetcom 471 8, 1 2 ) (Table 1) 1 6 14, 2 1 2 1 Ender 29

More information

Results of tibia nailing with Angular Stable Locking Screws (ASLS); A retrospective study of 107 patients with distal tibia fracture.

Results of tibia nailing with Angular Stable Locking Screws (ASLS); A retrospective study of 107 patients with distal tibia fracture. Results of tibia nailing with Angular Stable Locking Screws (ASLS); A retrospective study of 107 patients with distal tibia fracture. stud. med. David Andreas Lunde Hatfield stud. med. Mohammed Sherif

More information

Malaysian Orthopaedic Journal 2018 Vol 12 No 3

Malaysian Orthopaedic Journal 2018 Vol 12 No 3 doi: http://dx.doi.org/10.5704/moj.1811.004 Functional Outcome after Treatment of Aggressive Tumours in the Distal Radius: Comparison between Reconstruction using Proximal Fibular Graft and Wrist Fusion

More information

CASE REPORT. Bone transport utilizing the PRECICE Intramedullary Nail for an infected nonunion in the distal femur

CASE REPORT. Bone transport utilizing the PRECICE Intramedullary Nail for an infected nonunion in the distal femur PRODUCTS CASE REPORT Bone transport utilizing the PRECICE Intramedullary Nail for an infected nonunion in the distal femur Robert D. Fitch, M.D. Duke University Health System 1 1 CONDITION Infected nonunion

More information

BUILDING A. Achieving total reconstruction in a single operation. 70 OCTOBER 2016 // dentaltown.com

BUILDING A. Achieving total reconstruction in a single operation. 70 OCTOBER 2016 // dentaltown.com BUILDING A MANDI Achieving total reconstruction in a single operation by Dr. Fayette C. Williams Fayette C. Williams, DDS, MD, FACS, is clinical faculty at John Peter Smith Hospital in Fort Worth, Texas,

More information

EXPERT TIBIAL NAIL PROTECT

EXPERT TIBIAL NAIL PROTECT EXPERT TIBIAL NAIL PROTECT Enhance your first line of defense This publication is not intended for distribution in the USA. CLINICAL EVIDENCE CONTENT AUTHOR TITLE OF CHAPTER PAGE ETN PROtect clinical evidence

More information

DESCENDING BRANCH OF THE LATERAL CIRCUMFLEX FEMORAL ARTERY AS A RECIPIENT VESSEL FOR VASCULARIZED FIBULAR GRAFTS: CLINICAL CASE SERIES

DESCENDING BRANCH OF THE LATERAL CIRCUMFLEX FEMORAL ARTERY AS A RECIPIENT VESSEL FOR VASCULARIZED FIBULAR GRAFTS: CLINICAL CASE SERIES DESCENDING BRANCH OF THE LATERAL CIRCUMFLEX FEMORAL ARTERY AS A RECIPIENT VESSEL FOR VASCULARIZED FIBULAR GRAFTS: CLINICAL CASE SERIES GOKHAN MERIC, M.D., 1 ALI ENGIN ULUSAL, M.D., 1 AZIZ ATIK, M.D., 1

More information

Simultaneous Bilateral Patellar Tendon Ruptures Associated with Osteogenesis Imperfecta

Simultaneous Bilateral Patellar Tendon Ruptures Associated with Osteogenesis Imperfecta 432 pissn : 1226-2102, eissn : 2005-8918 Case Report J Korean Orthop Assoc 2016; 51: 432-436 https://doi.org/10.4055/jkoa.2016.51.5.432 www.jkoa.org Simultaneous Bilateral Patellar Tendon Ruptures Associated

More information

JPRAS Open 3 (2015) 1e5. Contents lists available at ScienceDirect. JPRAS Open. journal homepage:

JPRAS Open 3 (2015) 1e5. Contents lists available at ScienceDirect. JPRAS Open. journal homepage: JPRAS Open 3 (2015) 1e5 Contents lists available at ScienceDirect JPRAS Open journal homepage: http://www.journals.elsevier.com/ jpras-open Case report The pedicled transverse partial latissimus dorsi

More information

Clinical Study The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects

Clinical Study The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects Sarcoma Volume 2013, Article ID 321201, 7 pages http://dx.doi.org/10.1155/2013/321201 Clinical Study The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large

More information

The earlier clinic experience of the reverse-flow anterolateral thigh island flap

The earlier clinic experience of the reverse-flow anterolateral thigh island flap British Journal of Plastic Surgery (2005) 58, 160 164 The earlier clinic experience of the reverse-flow anterolateral thigh island flap Gang Zhou, Qi-Xu Zhang*, Guang-Yu Chen Scar Multiple Treatment Centre,

More information

Debate: I Do Bone Transport. Disclosures. Bone Defects 5/10/2017

Debate: I Do Bone Transport. Disclosures. Bone Defects 5/10/2017 Debate: I Do Bone Transport David W. Lowenberg, M.D. Clinical Pressor Department Orthopaedic Surgery Stanford University School Medicine Disclosures Board Directors: Foundation for Orthopaedic Trauma (FOT)

More information

Choice of spacer material for HTO! P. Landreau, MD Chief of Surgery Aspetar, Orthopaedic and Sports Medicine Hospital Doha, Qatar

Choice of spacer material for HTO! P. Landreau, MD Chief of Surgery Aspetar, Orthopaedic and Sports Medicine Hospital Doha, Qatar Choice of spacer material for HTO! P. Landreau, MD Chief of Surgery Aspetar, Orthopaedic and Sports Medicine Hospital Doha, Qatar High Tibial Osteotomy: HTO! Valgisation HTO Intended to transfer the mechanical

More information

CHAPTER 16 LOWER EXTREMITY. Amanda K Silva, MD and Warren Ellsworth, MD, FACS

CHAPTER 16 LOWER EXTREMITY. Amanda K Silva, MD and Warren Ellsworth, MD, FACS CHAPTER 16 LOWER EXTREMITY Amanda K Silva, MD and Warren Ellsworth, MD, FACS The plastic and reconstructive surgeon is often called upon to treat many wound problems of the lower extremity. These include

More information

The long term fate of the fibula when used as an intraosseous graft

The long term fate of the fibula when used as an intraosseous graft Acta Orthop. Belg., 2004, 70, 322-326 The long term fate of the fibula when used as an intraosseous graft Onkar N. NAGI, Mandeep S. DHILLON, Sameer AGGARWAL From the Post Graduate Institute of Medical

More information

Metastatic Disease of the Proximal Femur

Metastatic Disease of the Proximal Femur CASE REPORT Metastatic Disease of the Proximal Femur WI Faisham, M.Med{Ortho)*, W Zulmi, M.S{Ortho)*, B M Biswal, MBBS** 'Department of Orthopaedic, "Department of Oncology and Radiotherapy, School of

More information

Osteosynthesis involving a joint Thomas P Rüedi

Osteosynthesis involving a joint Thomas P Rüedi Osteosynthesis involving a joint Thomas P Rüedi How to use this handout? The left column contains the information given during the lecture. The column at the right gives you space to make personal notes.

More information

Techique. Results. Discussion. Materials & Methods. Vol. 2 - Year 1 - December 2005

Techique. Results. Discussion. Materials & Methods. Vol. 2 - Year 1 - December 2005 to each other. The most distal interlocking hole is 3 mm proximal to distal end of nail, is in anteroposterior direction & proximal distal interlocking hole is in medial to lateral direction i.e. at right

More information

Reconstruction of a Maxillary Oncologic Defect with a Fibula Osteocutaneous Flap. Using Synthes ProPlan CMF and the MatrixMIDFACE Plating System.

Reconstruction of a Maxillary Oncologic Defect with a Fibula Osteocutaneous Flap. Using Synthes ProPlan CMF and the MatrixMIDFACE Plating System. Case Report Reconstruction of a Maxillary Oncologic Defect with a Fibula Osteocutaneous Flap. Using Synthes ProPlan CMF and the MatrixMIDFACE Plating System. Reconstruction of a Maxillary Oncologic Defect

More information

Isolated congenital anterolateral bowing of the fibula : A case report with 24 years follow-up

Isolated congenital anterolateral bowing of the fibula : A case report with 24 years follow-up Acta Orthop. Belg., 2009, 75, 842-846 CASE REPORT Isolated congenital anterolateral bowing of the fibula : A case report with 24 years follow-up Karolien LELIEFELD, Hans VAN DER SLUIJS, Ibo VAN DER HAVEN

More information

Functional Outcome Study of Mega-Endoprosthetic Reconstruction in Limbs With Bone Tumour Surgery

Functional Outcome Study of Mega-Endoprosthetic Reconstruction in Limbs With Bone Tumour Surgery 192 Original Article Functional Outcome Study of Mega-Endoprosthetic Reconstruction in Limbs With Bone Tumour Surgery Peh Khee Tan, 1 MBBS, MRCS (Edin), MMed (Orthop), Mann Hong Tan, 1 MBBS, FRCS (Edin

More information

Calcium Phosphate Cement

Calcium Phosphate Cement Calcium Phosphate Cement Fast-Setting Bone Graft and AutoGraft Extender. * Ossilix is a high performance next generation calcium phosphate cement indicated for filling bony defects in cancellous bone.

More information

ILIZAROV TECHNIQUE IN CORRECTING LIMBS DEFORMITIES: PRELIMINARY RESULTS

ILIZAROV TECHNIQUE IN CORRECTING LIMBS DEFORMITIES: PRELIMINARY RESULTS Bahrain Medical Bulletin, Volume 17, Number 2, June 1995 Original ILIZAROV TECHNIQUE IN CORRECTING LIMBS DEFORMITIES: PRELIMINARY RESULTS Saleh W. Al-Harby, FRCS(Glasg)* This is a prospective study of

More information

Result of extracorporeal irradiation and re-implantation for malignant bone tumors: A review of 30 patients

Result of extracorporeal irradiation and re-implantation for malignant bone tumors: A review of 30 patients bs_bs_banner Asia-Pacific Journal of Clinical Oncology 2012 doi: 10.1111/ajco.12036 ORIGINAL ARTICLE Result of extracorporeal irradiation and re-implantation for malignant bone tumors: A review of 30 patients

More information

Ankle and subtalar arthrodesis

Ankle and subtalar arthrodesis OSTEOAMP Allogeneic Morphogenetic Proteins Ankle Nonunions OSTEOAMP Case Report ANKLE NONUNIONS Dr. Jason George DeVries Orthopedic & Sports Medicine, Bay Care Clinic, 501 N. 10th Street, Manitowoc, WI

More information

Elsevier Editorial System(tm) for Journal of Hand Surgery (British & European Volume)

Elsevier Editorial System(tm) for Journal of Hand Surgery (British & European Volume) Elsevier Editorial System(tm) for Journal of Hand Surgery (British & European Volume) Manuscript Draft Manuscript Number: Title: Double-Barrel Free Fibula Flap for Treatment of Infected Nonunion of Both

More information

Tibial deformity correction by Ilizarov method

Tibial deformity correction by Ilizarov method International Journal of Research in Orthopaedics http://www.ijoro.org Case Report DOI: http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20180422 Tibial deformity correction by Ilizarov method Robert

More information

Surgical treatment of aseptic nonunion in long bones: review of 193 cases

Surgical treatment of aseptic nonunion in long bones: review of 193 cases J Orthopaed Traumatol (2007) 8:11 15 DOI 10.1007/s10195-007-0155-z ORIGINAL A. Megaro S. Marchesi U.E. Pazzaglia Surgical treatment of aseptic nonunion in long bones: review of 193 cases Received: 5 September

More information

Nonunion of the Femur Treated with Conventional Osteosynthesis Combined with Autogenous and Strut Allogeneic Bone Grafts

Nonunion of the Femur Treated with Conventional Osteosynthesis Combined with Autogenous and Strut Allogeneic Bone Grafts Original Article 268 Nonunion of the Femur Treated with Conventional Osteosynthesis Combined with Autogenous and Strut Allogeneic Bone Grafts Lin-Hsiu Weng, MD; Jun-Wen Wang, MD Background: In this study,

More information

Medium- to Long-term Results of Strut Allografts Treating Periprosthetic Bone Defects

Medium- to Long-term Results of Strut Allografts Treating Periprosthetic Bone Defects ORIGINAL ARTICLE http://dx.doi.org/10.5371/hp.2018.30.1.23 Print ISSN 2287-3260 Online ISSN 2287-3279 Medium- to Long-term Results of Strut Allografts Treating Periprosthetic Bone Defects Jun Sung Park,

More information

Giant Cell Tumour of the Distal Radius: Wide Resection and Reconstruction by Non-vascularised Proximal Fibular Autograft

Giant Cell Tumour of the Distal Radius: Wide Resection and Reconstruction by Non-vascularised Proximal Fibular Autograft 900 Original Article Giant Cell Tumour of the Distal Radius: Wide Resection and Reconstruction by Non-vascularised Proximal Fibular Autograft Ayman Abdelaziz Bassiony, 1 MD Abstract Introduction: Giant

More information

Objectives. Limb salvage surgery. Age distribution bone cancer. Age distribution soft tissue sarcomas

Objectives. Limb salvage surgery. Age distribution bone cancer. Age distribution soft tissue sarcomas LifeSource October, 2011 Disclosure Information Putting humpty dumpty back together again is easier with tissue allografts! Limb Salvage Surgery for Bone Tumors Edward Cheng, MD October 6, 2011 Disclosure

More information

Versatility of Reverse Sural Artery Flap for Heel Reconstruction

Versatility of Reverse Sural Artery Flap for Heel Reconstruction ORIGINAL ARTICLE Introduction: The heel has two parts, weight bearing and non-weight bearing part. Soft tissue heel reconstruction has been a challenge due to its complex nature of anatomy, weight bearing

More information

Correction of Traumatic Ankle Valgus and Procurvatum using the Taylor Spatial Frame: A Case Report

Correction of Traumatic Ankle Valgus and Procurvatum using the Taylor Spatial Frame: A Case Report The Foot and Ankle Online Journal Official publication of the International Foot & Ankle Foundation Correction of Traumatic Ankle Valgus and Procurvatum using the Taylor Spatial Frame: A Case Report by

More information

The Open Orthopaedics Journal

The Open Orthopaedics Journal Send Orders for Reprints to reprints@benthamscience.ae 704 The Open Orthopaedics Journal, 2017, 11, (Suppl-4, M11) 704-713 The Open Orthopaedics Journal Content list available at: www.benthamopen.com/toorthj/

More information

Ethan M. Braunstein, M.D. 1, Steven A. Goldstein, Ph.D. 2, Janet Ku, M.S. 2, Patrick Smith, M.D. 2, and Larry S. Matthews, M.D. 2

Ethan M. Braunstein, M.D. 1, Steven A. Goldstein, Ph.D. 2, Janet Ku, M.S. 2, Patrick Smith, M.D. 2, and Larry S. Matthews, M.D. 2 Skeletal Radiol (1986) 15:27-31 Skeletal Radiology Computed tomography and plain radiography in experimental fracture healing Ethan M. Braunstein, M.D. 1, Steven A. Goldstein, Ph.D. 2, Janet Ku, M.S. 2,

More information

CASE REPORT Omentum Free Flap Anastomosed to Arterial Bypass in Open Knee Dislocation: Case Report and Discussion

CASE REPORT Omentum Free Flap Anastomosed to Arterial Bypass in Open Knee Dislocation: Case Report and Discussion CASE REPORT Omentum Free Flap Anastomosed to Arterial Bypass in Open Knee Dislocation: Case Report and Discussion Julien Pauchot, MD, PhD, a Emilie Ducroux, MD, b Grégoire Leclerc, MD, a Laurent Obert,

More information

North of England Bone and Soft Tissue Tumour Service

North of England Bone and Soft Tissue Tumour Service North of England Bone and Soft Tissue Tumour Service Guidelines for rehabilitation after proximal tibial replacement Proximal tibial replacement surgery is usually carried out as part of treatment for

More information

Interesting Case Series. Scalp Reconstruction With Free Latissimus Dorsi Muscle

Interesting Case Series. Scalp Reconstruction With Free Latissimus Dorsi Muscle Interesting Case Series Scalp Reconstruction With Free Latissimus Dorsi Muscle Danielle H. Rochlin, BA, Justin M. Broyles, MD, and Justin M. Sacks, MD Department of Plastic and Reconstructive Surgery,

More information

Reconstruction of a Mandibular Osteoradionecrotic Defect with a Fibula Osteocutaneous Flap.

Reconstruction of a Mandibular Osteoradionecrotic Defect with a Fibula Osteocutaneous Flap. Case Report Reconstruction of a Mandibular Osteoradionecrotic Defect with a Fibula Osteocutaneous Flap. Using Synthes ProPlan CMF, Patient Specific Plate Contouring (PSPC) and the MatrixMANDIBLE Plating

More information

A new classification system of nasal contractures

A new classification system of nasal contractures Original Article J Cosmet Med 2017;1(2):106-111 https://doi.org/10.25056/jcm.2017.1.2.106 pissn 2508-8831, eissn 2586-0585 A new classification system of nasal contractures Geunuck Chang 1, Donghak Jung

More information

Arthrodesis Using Pedicled Fibular Flap After Failed Infected Knee Arthroplasty

Arthrodesis Using Pedicled Fibular Flap After Failed Infected Knee Arthroplasty Arthrodesis Using Pedicled Fibular Flap After Failed Infected Knee Arthroplasty Steve C. Minear, MD, a,b Gordon Lee, MD, c David Kahn, MD, c and Stuart Goodman, MD, PhD d a Stanford University School of

More information

Vascularized Fibula Grafts

Vascularized Fibula Grafts Vascularized Fibula Grafts 311 16 Vascularized Fibula Grafts Clinical Applications Richard S. Gilbert, MD and Scott W. Wolfe, MD INTRODUCTION The reconstruction of large skeletal defects has posed a challenging

More information

USE OF THE IPSILATERAL VASCULARISED FIBULA FOR

USE OF THE IPSILATERAL VASCULARISED FIBULA FOR USE OF THE IPSILATERAL VASCULARISED FIBULA FOR TIBIAL RECONSTRUCTION R. HERTEL, M. PISAN, R. P. JAKOB From the University of Berne, Switzerland Between 1989 and 1994 we used a vascularised ipsilateral

More information

Distraction osteogenesis and arthrodesis as a new surgical option for chondrosarcoma in the distal tibia

Distraction osteogenesis and arthrodesis as a new surgical option for chondrosarcoma in the distal tibia Ouyang et al. World Journal of Surgical Oncology (2015) 13:187 DOI 10.1186/s12957-015-0604-8 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Distraction osteogenesis and arthrodesis as a new

More information

Ipsilateral Fibular Transport Using Ilizarov Taylor Spatial Frame for a Limb Salvage Reconstruction: a Case Report

Ipsilateral Fibular Transport Using Ilizarov Taylor Spatial Frame for a Limb Salvage Reconstruction: a Case Report DOI 10.1007/s11420-008-9102-7 CASE REPORT Ipsilateral Fibular Transport Using Ilizarov Taylor Spatial Frame for a Limb Salvage Reconstruction: a Case Report Raheel Shafi, MD& Austin T. Fragomen, MD & S.

More information

OSTEOCHONDRAL ALLOGRAFT RECONSTRUCTION FOR MASSIVE BONE DEFECT

OSTEOCHONDRAL ALLOGRAFT RECONSTRUCTION FOR MASSIVE BONE DEFECT OSTEOCHONDRAL ALLOGRAFT RECONSTRUCTION FOR MASSIVE BONE DEFECT Angelo J. Colosimo, MD -Head Orthopaedic Surgeon University of Cincinnati Athletics -Director of Sports Medicine University of Cincinnati

More information

Large segmental defects of the tibia caused by highenergy. Ten Year Experience with Use of Ilizarov Bone Transport for Tibial Defects

Large segmental defects of the tibia caused by highenergy. Ten Year Experience with Use of Ilizarov Bone Transport for Tibial Defects Bulletin Hospital for Joint Diseases Volume 61, Numbers 3 & 4 2003-2004 101 Ten Year Experience with Use of Ilizarov Bone Transport for Tibial Defects Gene D. Bobroff, M.D., Stuart Gold, M.D., and Daniel

More information

Fractures of allografts used in limb preserving operations

Fractures of allografts used in limb preserving operations Fractures of s used in limb preserving operations M. San-Julian, J. Cañadell Department of Orthopaedics, University of Navarra, Pamplona, Spain Reprint requests to: M. San-Julian Departamento de Cirugía

More information

Risk Factors for Hinge Fracture Associated with Surgery Following Cervical Open-Door Laminoplasty

Risk Factors for Hinge Fracture Associated with Surgery Following Cervical Open-Door Laminoplasty CLINICAL ARTICLE Korean J Neurotrauma 18;14(2):118-122 pissn 2234-8999 / eissn 2288-2243 https://doi.org/1.134/kjnt.18.14.2.118 Risk Factors for Hinge Fracture Associated with Surgery Following Cervical

More information

New Implantable Lengthening Nail: Preliminary Results. Matthew Harris MD, MBA Dror Paley MD, FRCS(C) Daniel Prince MD, MPH

New Implantable Lengthening Nail: Preliminary Results. Matthew Harris MD, MBA Dror Paley MD, FRCS(C) Daniel Prince MD, MPH New Implantable Lengthening Nail: Preliminary Results Matthew Harris MD, MBA Dror Paley MD, FRCS(C) Daniel Prince MD, MPH LLRS New York, NY July 19, 2013 Disclosures Dror Paley MD, FRCS(C) Paid Consultant

More information

A Clinical Anatomic Study of Internal Mammary Perforators as Recipient Vessels for Breast Reconstruction

A Clinical Anatomic Study of Internal Mammary Perforators as Recipient Vessels for Breast Reconstruction A Clinical Anatomic Study of Internal Mammary Perforators as Recipient Vessels for Breast Reconstruction In-Soo Baek 1, Jae-Pil You 1, Sung-Mi Rhee 1, Gil-Su Son 2, Deok-Woo Kim 1, Eun-Sang Dhong 1, Seung-Ha

More information

Plate Exposure after Reconstruction by Plate and Anterolateral Thigh Flap in Head and Neck Cancer Patients with composite mandibular Defects

Plate Exposure after Reconstruction by Plate and Anterolateral Thigh Flap in Head and Neck Cancer Patients with composite mandibular Defects Plate Exposure after Reconstruction by Plate and Anterolateral Thigh Flap in Head and Neck Cancer Patients with composite mandibular Defects Chia-Hsuan Tsai/ Huang-Kai Kao M. D. Introduction Malignant

More information

Medial Malleolus Fracture Fixation in the Setting of Concomitant Tibial Shaft Fractures

Medial Malleolus Fracture Fixation in the Setting of Concomitant Tibial Shaft Fractures Medial Malleolus Fracture Fixation in the Setting of Concomitant Tibial Shaft Fractures Stephen R. Barchick 1, BA Andrew P. Matson 2, MD Samuel B. Adams 2, MD 1. Duke University School of Medicine, Durham,

More information

Is Distraction Histiogenesis a Reliable Method to Reconstruct Segmental Bone and Acquired Leg Length Discrepancy in Tibia Fractures and Non Unions?

Is Distraction Histiogenesis a Reliable Method to Reconstruct Segmental Bone and Acquired Leg Length Discrepancy in Tibia Fractures and Non Unions? Is Distraction Histiogenesis a Reliable Method to Reconstruct Segmental Bone and Acquired Leg Length Discrepancy in Tibia Fractures and Non Unions? James J Hutson Jr MD Professor Orthopedic Trauma Ryder

More information

Abstract. Firas T. Ismaeel, Dept. of Surgery, College of Medicine, Tikrit University

Abstract. Firas T. Ismaeel, Dept. of Surgery, College of Medicine, Tikrit University Bone marrow injection in patients with delayed union and non-union of long Firas T. Ismaeel, Dept. of Surgery, College of Medicine, Tikrit University Abstract In the process of bone formation and healing

More information

Back out of Locking Pin with Hinge Fracture after High Tibial Osteotomy

Back out of Locking Pin with Hinge Fracture after High Tibial Osteotomy Case Report Knee Surg Relat Res 2018;30(2):171-175 https://doi.org/10.5792/ksrr.17.034 pissn 2234-0726 eissn 2234-2451 Knee Surgery & Related Research Back out of Locking Pin with Hinge Fracture after

More information

Does Intraoperative Navigation Assistance Improve Bone Tumor Resection and Allograft Reconstruction Results?

Does Intraoperative Navigation Assistance Improve Bone Tumor Resection and Allograft Reconstruction Results? Clin Orthop Relat Res DOI 10.1007/s11999-014-3604-z Clinical Orthopaedics and Related Research A Publication of The Association of Bone and Joint Surgeons SYMPOSIUM: 2013 MEETINGS OF THE MUSCULOSKELETAL

More information

Management of a large post-traumatic skin and bone defect using an Ilizarov frame

Management of a large post-traumatic skin and bone defect using an Ilizarov frame Acta Orthop. Belg., 2006, 72, 214-218 TECHNICAL NOTE Management of a large post-traumatic skin and bone defect using an Ilizarov frame Pieter D HOOGHE, Koen DEFOORT, Johan LAMMENS, Jos STUYCK From the

More information

INTRODUCTION. Jong Gyu Kim, Soo Hyang Lee. Original Article

INTRODUCTION. Jong Gyu Kim, Soo Hyang Lee. Original Article Comparison of the Multidetector-row Computed Tomographic ngiography xial and Coronal Planes Usefulness for Detecting Thoracodorsal rtery Perforators Original rticle Jong Gyu Kim, Soo Hyang Lee Department

More information

SURGERY OF THE HAND. Basosquamous Carcinoma of the Hand in a Radiologist with Prolonged Radiation Exposure INTRODUCTION CASE REPORT CASE REPORT

SURGERY OF THE HAND. Basosquamous Carcinoma of the Hand in a Radiologist with Prolonged Radiation Exposure INTRODUCTION CASE REPORT CASE REPORT CASE REPORT pissn 1598-3889 eissn 2234-0998 J Korean Soc Surg Hand 2016;21(3):162-166. http://dx.doi.org/10.12790/jkssh.2016.21.3.162 JOURNAL OF THE KOREAN SOCIETY FOR SURGERY OF THE HAND Basosquamous

More information

Surgical Management of aseptic Femoral Shaft Non-union after Intramedullary Fixation

Surgical Management of aseptic Femoral Shaft Non-union after Intramedullary Fixation The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (7), Page 4946-4950 Surgical Management of aseptic Femoral Shaft Non-union after Intramedullary Fixation Eissa Ragheb Refaie 1, Ahmed Abd El

More information

Limb salvage in osteosarcoma using autoclaved tumor-bearing bone

Limb salvage in osteosarcoma using autoclaved tumor-bearing bone Pan et al. World Journal of Surgical Oncology 2012, 10:105 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Open Access Limb salvage in osteosarcoma using autoclaved tumor-bearing bone Kok Long Pan 1*, Wai

More information

Outcome of Treatment of Nonunion Tibial Shaft Fracture by Intramedullary Interlocking Nail augmentated with Autogenous Cancellous Bone Graft.

Outcome of Treatment of Nonunion Tibial Shaft Fracture by Intramedullary Interlocking Nail augmentated with Autogenous Cancellous Bone Graft. Original Article Nepal Med Coll J 2014; 16(1): 58-62 Outcome of Treatment of Nonunion Tibial Shaft Fracture by Intramedullary Interlocking Nail augmentated with Autogenous Cancellous Bone Graft. Shah SB,

More information

Treatment of ipsilateral femoral neck and shaft fractures. Mohamed E. Habib, Yasser S. Hannout, and Ahmed F. Shams

Treatment of ipsilateral femoral neck and shaft fractures. Mohamed E. Habib, Yasser S. Hannout, and Ahmed F. Shams Treatment of ipsilateral femoral neck and shaft fractures Mohamed E. Habib, Yasser S. Hannout, and Ahmed F. Shams Department of Orthopedic Surgery, Faculty of Medicine, University of El Minoufiya, Egypt

More information

Failed Extensor Indicis Proprius Tendon Transfer for Extensor Pollicis Longus Tendon Rupture after Distal Radial Fracture

Failed Extensor Indicis Proprius Tendon Transfer for Extensor Pollicis Longus Tendon Rupture after Distal Radial Fracture CASE REPORT pissn 1598-3889 eissn 2234-0998 J Korean Soc Surg Hand 2015;20(1):23-27. http://dx.doi.org/10.12790/jkssh.2015.20.1.23 JOURNAL OF THE KOREAN SOCIETY FOR SURGERY OF THE HAND Failed Extensor

More information

Bone Void Filler. Callos. The Next Generation in Calcium Phosphate Cement A COLSON ASSOCIATE

Bone Void Filler. Callos. The Next Generation in Calcium Phosphate Cement A COLSON ASSOCIATE Callos Bone Void Filler The Next Generation in Calcium Phosphate Cement A COLSON ASSOCIATE Callos Calcium Phosphate Cement Callos is a high performance next generation calcium phosphate cement indicated

More information

The Effect of Bone Marrow Aspirate Concentrate (BMAC) and Platelet-Rich Plasma (PRP) during Distraction Osteogenesis of the Tibia

The Effect of Bone Marrow Aspirate Concentrate (BMAC) and Platelet-Rich Plasma (PRP) during Distraction Osteogenesis of the Tibia The Effect of Bone Marrow Aspirate Concentrate (BMAC) and Platelet-Rich Plasma (PRP) during Distraction Osteogenesis of the Tibia Dong Hoon Lee, MD, Ph.D, Keun Jung Ryu MD Limb Lengthening and Deformity

More information

Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture

Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture Strat Traum Limb Recon (2013) 8:127 131 DOI 10.1007/s11751-013-0167-6 CASE REPORT Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture Fatih

More information

Knee joint preservation surgery in osteosarcoma using tumour-bearing bone treated with liquid nitrogen

Knee joint preservation surgery in osteosarcoma using tumour-bearing bone treated with liquid nitrogen International Orthopaedics (SICOT) (2017) 41:2189 2197 DOI 10.1007/s00264-017-3499-x ORIGINAL PAPER Knee joint preservation surgery in osteosarcoma using tumour-bearing bone treated with liquid nitrogen

More information

CASE REPORT. Antegrade tibia lengthening with the PRECICE Limb Lengthening technology

CASE REPORT. Antegrade tibia lengthening with the PRECICE Limb Lengthening technology CASE REPORT Antegrade tibia lengthening with the PRECICE Limb Lengthening technology Austin T. Fragomen, M.D. Hospital for Special Surgery New York, NY 1 1 PR O D U CTS CONDITION Nonunion of an attempted

More information

Symptoms and signs associated with benign and malignant proximal fibular tumors: a clinicopathological analysis of 52 cases

Symptoms and signs associated with benign and malignant proximal fibular tumors: a clinicopathological analysis of 52 cases Sun et al. World Journal of Surgical Oncology (2017) 15:92 DOI 10.1186/s12957-017-1162-z RESEARCH Open Access Symptoms and signs associated with benign and malignant proximal fibular tumors: a clinicopathological

More information

.org. Tibia (Shinbone) Shaft Fractures. Anatomy. Types of Tibial Shaft Fractures

.org. Tibia (Shinbone) Shaft Fractures. Anatomy. Types of Tibial Shaft Fractures Tibia (Shinbone) Shaft Fractures Page ( 1 ) The tibia, or shinbone, is the most common fractured long bone in your body. The long bones include the femur, humerus, tibia, and fibula. A tibial shaft fracture

More information