Reconstruction of Metaphyseal Defect of Large Long Tubular Bone with Double Barreled Fibular Graft

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Journal of the Korean Society for Surgery of the Hand 2005;14(1):50-56.
Published online May 31, 2005.

Duke Whan Chung, M.D., Jun Young Park, M.D.

중첩한 비골 이식술을 이용한 대형 장골의 골 간단부 결손의 재건

정덕환·박준영

Abstract

  There are limited treatment options in the reconstruction of the very large defect in the metaphy - seal portion of distal femur and proximal tibia. Fibula is one of the most popular donor of the long bone reconstruction in reconstructive microsurgical field. It has many advantages such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter and long pedicle. There are limited donor site problems such as transient peroneal nerve dysfunction. In those situations with the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transferred. We performed 7 cases of “doule barrel”fibular transplantation on the metaphyseal portion of distal femur and proximal tibial large defects in which it is very difficult to fill the bony gap with conventional bone graft or callotasis methods. It takes averaged 8.3 months since that procedure to obtain bony union. After solid union of the transferred double barrelled fibular graft. There were no stress fracture in our series. So we can propose double barrel fibular graft is useful method in those cases with very large bone defect on the metaphysis of large long bone.

Key Words: Double barreled fibular graft, Long bone reconstruction, Bone defect

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