Reconstruction of Tibia Defect with Free Flap Followed by Ipsilateral Vascularized Fibular Transposition

Hwang,  Jung Chul; Chung,  Duke Whan; Han,  Chung Soo; Lee,  Jae Hoon; Ko,  Taeg Su; Park,  Yang Woo; Park,  Jin Sung

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Original Article

Journal of the Korean Society for Surgery of the Hand 2008;17(2):68-74.
Published online May 31, 2008.

Reconstruction of Tibia Defect with Free Flap Followed by Ipsilateral Vascularized Fibular Transposition

Jung Chul Hwang, M.D., Duke Whan Chung, M.D., Chung Soo Han, M.D., Jae Hoon Lee, M.D., Taeg Su Ko, M.D., Yang Woo Park, M.D., Jin Sung Park, M.D.

Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea. dukech@khmc.or.kr

유리 피판술과 동측 혈관 부착 비골 전위술을 이용한 경골 결손의 재건

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Abstract

  Segmental defects of the tibia after open fractures, sepsis and a tumor surgery are among the most difficult and challenging clinical problems. Tibia defects in these situations are complicated with infection and are resistant to conventional bone grafting techniques. The aim of this study is to report the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of tibia defects. Ten patients had free flap followed by IVFT in the period 1989~2007. Mean age was 25.3 years. The patients were followed for an average of 3.4 years. All flaps were survived including 1 case with venous thrombosis requiring additional surgery. The average time to union of proximal and distal end was 5.2 months, 8.2 months, each other. All transposed fibula were viable at last follow-up. IVFT offers the advantages of a vascularized graft. In patients with large bone and soft tissue defects combined with infection, free flap followed by IVFT is an useful and reliable method without microvascular anastomosis.

Key Words: Tibia defect, Free flap, Ipsilateral vascularized fibular transposition

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