Reconstruction of Wrist Joint Using Vascularized Free Fibular Head Graft After the Wide Tumor Excision of Distal Radius

Song,  Seok Whan; Lee,  Yoon Min

doi:2011.20.1.82

Arch Hand Microsurg > Volume 20(1); 2011 > Article

Review

Journal of the Korean Society for Surgery of the Hand 2011;20(1):82-88.
Published online May 31, 2011.
DOI: https://doi.org/10.12790/jkssh.2011.20.1.82

Reconstruction of Wrist Joint Using Vascularized Free Fibular Head Graft After the Wide Tumor Excision of Distal Radius

Seok-Whan Song, M.D., DMSc, Yoon-Min Lee, M.D.

Department of Orthopedic Surgery, The Catholic University of Korea, Korea. sw.song@catholic.ac.kr

원위 요골 악성 종양의 광범위 절제술 후 혈행성 유리 비골 두 이식을 이용한 수근관절 재건술

Abstract

Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.

Key Words: Distal radius malignancy, Vascularized fibular head graft, Wrist reconstruction