四肢悪性腫瘍切除後の組織欠損に対する遊離血管柄付き腓骨移植術を用いた再建

抄録

Between 1988 and 2007, eighteen cases were reconstructed by free vascularized fibula grafts after wide resection of sarcoma of the long bones. Cases consisted of eight males and ten females with an average age of 23 years (range, 7 to 65 years). The length of the fibula ranged from 15 to 26 cm (average: 20.9 cm). Follow-up periods ranged from 32 to 228 months (average: 137 months).
In ten patients, free vascularized fibula was transferred to arthrodesis the knee or the ankle joints after tumor resection. The mean time for bone union was 5.4 months. Peroneal nerve palsy was observed in three patients and stress fracture in four of 10 patients. Four patients underwent reconstruction of a long bone intercalary defect with bilateral fibulas used for reconstruction of femoral defects in three of these patients. A sling procedure was performed for reconstruction after wide resection of the proximal humerus for malignant bone tumor in the remaining four patients. Three of four patients had absorption of the head of the fibula probably due to a deficient blood supply through the peroneal artery.