Ankle Instability After Vascularized Fibular Harvest for Tumor Reconstruction

Nathan, Saminathan S.; Lee, Hung-yi; Disa, Joseph J.; Athanasian, Edward A.; Boland, Patrick J.; Cordeiro, Peter G.; Healey, John H.

doi:10.1007/s10434-004-1162-4

Cited by 38 publications

(39 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When longer defects have to be reconstructed, the use of fibula graft or allograft may offer an advantage over ICBG. Harvesting of autogenous fibula is not without risk and complications [26] including foot drop, painful neuromas, ankle instability [28] and ankle valgus deformity [27]. The use of nonvascularized ICBG for reconstruction of postresection defects of the distal radius has several advantages over some of the other techniques described.…”

Section: Discussionmentioning

confidence: 99%

Does Wrist Arthrodesis With Structural Iliac Crest Bone Graft After Wide Resection of Distal Radius Giant Cell Tumor Result in Satisfactory Function and Local Control?

Wang

Chan

Yang

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Many techniques have been described for reconstruction after distal radius resection for giant cell tumor with none being clearly superior. The favored technique at our institution is total wrist fusion with autogenous nonvascularized structural iliac crest bone graft because it is structurally robust, avoids the complications associated with obtaining autologous fibula graft, and is useful in areas where bone banks are not available. However, the success of arthrodesis and the functional outcomes with this approach, to our knowledge, have only been limitedly reported. Questions/purposes (1) What is the success of union of these grafts and how long does it take? (2) How effective is the technique in achieving tumor control? (3) What complications occur with this type of arthrodesis? (4) What are the functional results of wrist arthrodesis by this technique for treating giant cell tumor of the distal radius? Methods Between 2005 and 2013, 48 patients were treated for biopsy-confirmed Campanacci Grade III giant cell tumor of the distal radius. Of those, 39 (81% [39 of 48]) were treated with wrist arthrodesis using autogenous nonvascularized iliac crest bone graft. Of those, 27 (69% [27 of 39]) were available for followup at a minimum of 24 months (mean, 45 months; range, 24-103 months). During that period, the general indications for this approach were Campanacci Grade III and estimated resection length of 8 cm or less. Followup included clinical and radiographic assessment and functional assessment using the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Musculoskeletal Tumor Society (MSTS) score, grip strength, and range of motion at every followup by the treating surgeon and his team. All functional results were from the latest followup of each patient. Results Union of the distal junction occurred at a mean of 4 months (± 2 months) and union of the proximal junction occurred at a mean of 9 months (± 5 months). Accounting for competing events, at 12 months, the rate of proximal junction union was 56% (95% confidence interval [CI], 35%-72%), whereas it was 67% (95% CI, 45%-82%) at 18 months. In total, 11 of the 27 patients (41%) underwent repeat surgery on the distal radius, including eight patients (30%) who had complications and three (11%) who had local recurrence. The mean DASH score was 9 (± 7) (value range, 0-100, with lower scores representing better function), and the mean MSTS 1987 score was 29 (± 1) (value range, 0-30, with higher scores representing better function) as well as 96% (± 4%) of mean MSTS 1993 score (value range, 0%-100%, with higher scores representing

show abstract

Section: Discussionmentioning

confidence: 99%

Does Wrist Arthrodesis With Structural Iliac Crest Bone Graft After Wide Resection of Distal Radius Giant Cell Tumor Result in Satisfactory Function and Local Control?

Wang

Chan

Yang

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…33 Progression of the deformity is fostered by the development of a growth disorder at the lateral tibial epiphysis. 32,33 How the growth disorder develops is controversial. Nathan et al ascribes the growth disorder to anteromedial rotation of the proximal part of remnant distal fibula, impaction of the remnant fibula tip onto the tibial diaphysis, and lateral tibial physeal lysis, which could conceivably result in necrosis of the lateral tibial growth plate, permitting the relative overgrowth of the medial tibial physis versus the lateral tibial physis.…”

Section: Complicationsmentioning

confidence: 99%

“…The development of the valgus deformity is characterized by proximal migration of the fibula. 32,33,34 The proximal migration is thought due to the force transmission from the talus and muscle action of the peroneal muscles. 33 It is this proximal migration of the fibula that results in the ankle valgus deformity.…”

Section: Complicationsmentioning

confidence: 99%

Physeal Transfers for Skeletal Reconstruction

Akinbo

Strauch

2008

The Journal of Hand Surgery

View full text Add to dashboard Cite

“…Questionnaire results [1,3,30,36], disability scales [1,10,25], or gait analyses [3,25] have been reported in some studies, and disabilities such as pain, ankle instability, and inability to run have been described [1,3,10,18,25,30,32,36]. Other studies have attempted quantitative analyses of long-term side effects based on radiographs [2,10,14,28,30]. Most of these studies, however, focused on ankle deformities [2,10,28,30], and only one described thickening of the tibial lateral cortex [14].…”

Section: Introductionmentioning

confidence: 99%

“…Other studies have attempted quantitative analyses of long-term side effects based on radiographs [2,10,14,28,30]. Most of these studies, however, focused on ankle deformities [2,10,28,30], and only one described thickening of the tibial lateral cortex [14]. In contrast, experimental studies performed on animals have reported quantitative analyses of radius adaptation after ulna resection for pigs [15] and sheep [23,26].…”

Section: Introductionmentioning

confidence: 99%

Tibia Adaptation after Fibula Harvesting: An in Vivo Quantitative Study

Taddei

Balestri

Rimondi

et al. 2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Absence of the fibula after harvesting to reconstruct an upper-limb segment increases loads on the donor-side tibia and thereby provides a unique opportunity to analyze the bone adaptation process in humans. We therefore quantified densitometric and morphologic changes of the donor-side tibia in three young patients (ages 8, 13, 16 years), on the basis of computed tomography (CT) examinations of both legs (one preoperatively and two postoperatively). The range of final followup was 27-43 months. Three-dimensional models of shank bones were generated from CT data and used to measure crosssectional area, diaphyseal cortical thickness, and crosssectional moment of inertia. In addition, density of the newly formed bone was evaluated. The donor-side tibia showed morphologic and density adaptation with time.

show abstract

Ankle Instability After Vascularized Fibular Harvest for Tumor Reconstruction

Abstract: Our series suggests that children with an age-length sum <16 should be considered for prophylactic tibiofibular synostosis creation.

Cited by 38 publications

References 27 publications

Does Wrist Arthrodesis With Structural Iliac Crest Bone Graft After Wide Resection of Distal Radius Giant Cell Tumor Result in Satisfactory Function and Local Control?

Does Wrist Arthrodesis With Structural Iliac Crest Bone Graft After Wide Resection of Distal Radius Giant Cell Tumor Result in Satisfactory Function and Local Control?

Physeal Transfers for Skeletal Reconstruction

Tibia Adaptation after Fibula Harvesting: An in Vivo Quantitative Study

Contact Info

Product

Resources

About