The vascularised fibular graft for limb salvage after XXXX surgery: a multicentre study.

@entity5 @entity1 @entity1184 @entity174
Vascularised fibular grafts (VFGs ) are a valuable surgical technique in limb salvage after resection of a @entity5 . The primary objective of this multicentre study was to assess the risk factors for failure and complications for using a VFG after resection of a @entity5 . The study involved 74 consecutive @entity1 (45 @entity1 and 29 @entity1 with mean age of 23 years (1 to 64) from four tertiary centres for orthopaedic oncology who underwent reconstruction using a VFG after resection of a @entity5 between 1996 and 2011. There were 52 primary and 22 secondary reconstructions. The mean follow-up was 77 months (10 to 195). In all, 69 @entity1 (93%) had successful limb salvage; all of these united and 65 (88%) showed @entity1184 of the graft. The mean time to union differed between those involving the upper (28 weeks; 12 to 96) and lower limbs (44 weeks; 12 to 250). @entity174 occurred in 11  (15%), and nonunion in 14 (19%) @entity1 . In 35 @entity1 (47%) at least one complication arose, with a greater proportion in lower limb reconstructions, non-bridging osteosynthesis, and in @entity1 . These complications resulted in revision surgery in 26 @entity1 (35%). VFG is a successful and durable technique for reconstruction of a defect in bone after resection of a @entity5 , but is accompanied by a significant risk of complications, that often require revision surgery. Union was not markedly influenced by the need for chemo- or radiotherapy, but should not be expected during chemotherapy. Therefore, restricted weight-bearing within this period is advocated. Cite this article: Bone Joint J 2015;97-B:853-61.
