We reconstructed large bony defects of the humerus using a fibula head graft in four cases. In one of the four patients the large bony humeral defect was caused by osteomyelitis of the humerus, while the other three were due to parosseal osteosarcomas of the humerus. Free vascularized proximal fibula grafting was performed in three cases. In the other case a proximal fibula graft using the fibula head was performed. The mean follow-up period was 4·5 years. All cases were evaluated according to their JOA score and the was functionally evaluated reconstructive procedure following surgical treatment of the musculoskeletal tumor according to Enneking.
In two patients under 40 years of age both the JOA score and % Rating of Enneking's evaluation were significantly higher than in patients aged over 40 years.
We concluded that a free vascularized fibula graft is a very useful procedure for treating large bony defects of the humerus.
