A new autogenous graft choice in pelvic reconstructions: free vascularized rib (a case report)

Abstract

Primary or secondary bone tumours are not uncommon in pelvic girdle. In some cases, after radical resection, there is a big bony defect where the prosthesis is not applicable; arthrodesis is the only choice for good functional results. In this instance, the major problem is to achieve the fusion. In this case report, we focused on easy harvesting and minimal time consumption with free vascularized rib graft to achieve the fusion between the resected segments. Two year follow up showed fusion with good functional result.

The use of vascularized fibular grafts for the reconstruction of spinal and sacral defects

“…15,43 Posterior placement of the vascularized rib graft was recently reported by Wilden et al 39 Further variations of pedicled vascularized bone have included pedicled iliac crest bone graft for sacral reconstruction 44 and lumbosacral fusion 45 as well as free vascularized rib grafts for pelvic reconstruction. 46 While pedicled vascularized rib provides a technically straightforward and generally successful means of augmenting spinal reconstruction, this technique is inadequate for cases of infection, reconstruction following radiation, large tumor resections, and resections occurring outside of the thoracic vertebrae. Historically, free vascularized bone grafts to the spine have been typically performed for patients who have spine tumors requiring multiple level vertebrectomies, have undergone failed previous attempts at spine arthrodesis, or have significantly poor soft tissue beds that have developed secondary to infection (i.e.…”

Primary Reconstruction of Mandibular Defects after Resection of Aggressive Pediatric Mandibular Tumors by Split Rib Bundle Bone Graft. A Retrospective Study

“…Ribs have often been used as free non-vascularised grafts [4,7,10,11] and, in recent years also as pedicled and free revascularized flaps [18,[28][29][30][31][32][33][34][35][36] . Such grafts may be either osseous, cartilaginous, or a combination of the two as a costochondral graft (CCG).…”

The Role of Vascularized Bone Grafts in Spine Surgery

“…The use of free vascularized rib grafts have been described [54] and applied to sacral reconstruction after tumor excision in one case [24].…”

“…Modifications and refinement of techniques of each of the vascularized bone grafts have occurred, which resulted in increased usefulness and application to a variety of spine maladies. Other reported vascularized bone grafts to the spine include the pedicled iliac crest bone graft for sacral reconstruction [22] and lumbosacral fusion [23], as well as free vascularized rib grafts for pelvic reconstruction [24].…”