Reconstruction of Pelvic-ring Defect using Vascularized Bone Grafts from both Iliac Crest and Fibula

Abstract

Two patients with malignant pelvic tumors were treated at our institution. The first patient, a 68-year old man, had a metastatic tumor from renal cancer found out on Feburauary in 2001.
The other was a 71-year-old woman with a malignant fibrous histocytoma found out on April in 2001.
After extensive resection of the tumors in the ileum, reconstruction was performed using combined vascularized bone grafts from the iliac crest and fibula. The former were pedicular and the later were free grafts.
Postoperative course of the first case was uneventful. The patient could walk with a crutch, and returned to his previous occupation. Despite a local recurrence in the second case, the integrity of her pelvis was maintained successfully.
The authors used the pedicle iliac bone graft, because the corresponding area of the ilium could be saved for the tumor resection. Combined use of the two vascularized bone graft offers : increased stability, and both grafts can compensate for each other.
Although the technique used in these cases limited indication, it has apparent advantage over the classic reconstruction.