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S Falder, J.S Sinclair, C.A Rogers, P.L.G Townsend 

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Presentation on theme: "S Falder, J.S Sinclair, C.A Rogers, P.L.G Townsend "— Presentation transcript:

1 Long-term behaviour of the free vascularised fibula following reconstruction of large bony defects 
S Falder, J.S Sinclair, C.A Rogers, P.L.G Townsend  British Journal of Plastic Surgery  Volume 56, Issue 6, Pages (September 2003) DOI: /S (03)

2 Fig. 1 Excision of osteosarcoma of the tibia, creating a 14 cm defect.
British Journal of Plastic Surgery  , DOI: ( /S (03) )

3 Fig. 2 Localised callus identifying the site of previous stress fracture of the transferred fibula. British Journal of Plastic Surgery  , DOI: ( /S (03) )

4 Fig. 3 Hypertrophy is calculated by measurement of maximum and minimum transferred fibula widths on (A) the immediate post-operative X-ray film and (B) at last follow-up. British Journal of Plastic Surgery  , DOI: ( /S (03) )

5 Fig. 4 (A) Post-operative X-ray film showing a ‘double-barrelled’ free fibula graft used to reconstruct the distal femur. (B) X-ray film of the same patient 8 years later, showing marked hypertrophy of the fibula. British Journal of Plastic Surgery  , DOI: ( /S (03) )

6 Fig. 5 Post-operative X-ray film showing use of the free fibula, in a patient with fibrous dysplasia of the femur with coxa vara. British Journal of Plastic Surgery  , DOI: ( /S (03) )

7 Fig. 6 Graph showing the relationship between time to bony union and bony gap. British Journal of Plastic Surgery  , DOI: ( /S (03) )

8 Fig. 7 To maintain the fibula in correct alignment, we use a modified Ilizarov frame, designed by an orthopaedic colleague.26 During surgery to transfer the fibula, part of the frame can be removed. British Journal of Plastic Surgery  , DOI: ( /S (03) )

9 Fig. 8 Bowing of the transferred fibula can be seen in this lateral X-ray film, taken 6 years after surgery. This was due to use of a unilateral fixator. British Journal of Plastic Surgery  , DOI: ( /S (03) )

10 Fig. 9 (A) The post-operative views of fibula transfer into the radius. The fibula appears to be the same width as the recipient bone. (B) Pre-operative views of the same patient. British Journal of Plastic Surgery  , DOI: ( /S (03) )

11 Fig. 10 Hypertrophy of the transferred fibula 9 years after surgery, is seen to extend beyond the original diameter of the recipient femur. This occurs along the whole length of the fibula, and is not the result of localised callus. British Journal of Plastic Surgery  , DOI: ( /S (03) )


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