Long-term behaviour of the free vascularised fibula following reconstruction of large bony defects

Falder, Sian; Sinclair, Jennifer; Rogers, Chris; Townsend, P.L.G.

doi:10.1016/s0007-1226(03)00186-3

Cited by 37 publications

(28 citation statements)

References 46 publications

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“…This translates radiographically into a hypertrophy. A number of parameters such as the age of the patient, vascular condition and the type of hardware used for fixation may influence this process [32].…”

Section: Discussionmentioning

confidence: 99%

Free fibula flap for humerus segmental reconstruction: report on 13 cases

et al. 2008

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In the period between 1994 and 2004, 13 patients (10 male, 3 female) presenting with post-traumatic defects to the humerus were treated with vascularised fibula graft. Age ranged from 21 to 62 (mean 37) years. Length of the bony defect ranged from 6 to 16 cm. Graft fixation was performed with plates in 12 cases, and in one case only screws were used. All patients were clinically reviewed between 120 days and 14 months after surgery. In one patient the flap was lost and a second free fibula flap was performed to achieve the reconstructive goal. Mean time for segmental bony union was 6 months (range from 3 to 13 months). Vascularised fibula graft allows for a successful humerus reconstruction when traditional techniques provide unsatisfactory results.

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Section: Discussionmentioning

confidence: 99%

Free fibula flap for humerus segmental reconstruction: report on 13 cases

et al. 2008

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“…26 When plastic surgeons transplant a fibula to replace a tibia that has been destroyed by tumor or infection, the fibula quickly hypertrophies and comes to resemble a tibia. 27 Conversely, disorders that result in removal of mechanical stimulus during growth, such as cerebral palsy, spina bifida, or poliomyelitis, lead to thin bones in the affected segments. [28][29][30] …”

Section: The Control Of Periosteal Bone Growthmentioning

confidence: 99%

Bone Accrual in Children: Adding Substance to Surfaces

Rauch

2007

Pediatrics

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The mass of growing bones increases through changes in outer dimensions and through the net addition of tissue on inner bone surfaces. In this overview I examine bone accrual as it occurs on trabecular (inner) and periosteal (outer) surfaces. In the axial skeleton, the amount of trabecular bone increases during development, because trabeculae grow thicker as a result of bone remodeling with a positive balance. Remodeling is a process in which osteoblasts and osteoclasts are tightly linked ("coupled") in time and space. In contrast to trabecular thickness, trabecular number and material density change little throughout development. Bone accrual on periosteal surfaces leads to an increase in bone size, which is a crucial determinant of bone strength throughout life. Periosteal osteoblasts deposit new bone on an extended surface area and over an extended period of time without being interrupted by osteoclasts. This type of bone metabolic activity is called modeling, which is much more efficient than remodeling for increasing bone mass. In the past, research has focused on bone remodeling on trabecular surfaces. However, the key to an improved understanding of bone mass and strength development in children will lie with studies on bone modeling on periosteal surfaces.www.pediatrics.org/cgi

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“…13,15,21,30 Once positioned into the recipient site, the fibula is capable of undergoing a remodeling process that can sustain the new functional load. 11 This translates radiographically into hypertrophy (Figure 2). A number of variables, such as the age of the patient, the vascular conditions, and the type of hardware used for fixation, may influence this process.…”

Section: Discussionmentioning

confidence: 99%