Pelvic Ring Reconstruction with the Double-Barreled Vascularized Fibular Free Flap

Abstract

The double-barreled fibular graft is well vascularized and can achieve satisfactory bone union. It is a safe and effective method for reconstructing the pelvic ring. Furthermore, the Cotrel-Dubousset rod system can provide rigid fixation soon after surgery and is useful for early rehabilitation of walking.

Constrained Total Hip Megaprosthesis for Primary Periacetabular Tumors

“…However, limb-salvage reconstruction of malignant pelvic tumors, especially in the periacetabular region, remains challenging because of the complex anatomy, the difficulty achieving wide surgical margins, and large bone and soft tissue defects after tumor resection. The reconstructive options include resection arthroplasty [7,30,33], iliofemoral or ischiofemoral arthrodesis [9,12], hip transposition method (pseudarthrosis) [3,12,32], free-vascularized fibular graft for pelvic ring reconstruction [29], allograft [2,22,23,26,39], recycled autologous bone graft [16,20], and endoprosthetic replacement [1,4,11,14,18,21,24,25,27,28,34,[36][37][38]. However, no standard reconstructive procedure exists after internal hemipelvectomy for malignant periacetabular tumors.…”

A new type of reconstruction of the hemipelvis after Type 3 amputative sacrectomy using pedicled fibula

“…2,11,18,41,48 Yajima and Tamai reported 2 cases of pelvic reconstruction using double-strut vascularized fibula flaps. 59 Sakuraba et al 48 reported their experience with 5 cases of Type I and Type II hemipelvectomy defects that were reconstructed with double-barreled vascularized fibula flaps. In this series, flaps were successful in 4 patients, and 3 patients were able to ambulate independently.…”

“…7,11,48,61 Autologous bony reconstruction of the pelvis using fibula has been described in the literature. 2,11,18,41,48 Yajima and Tamai reported 2 cases of pelvic reconstruction using double-strut vascularized fibula flaps. 59 Sakuraba et al 48 reported their experience with 5 cases of Type I and Type II hemipelvectomy defects that were reconstructed with double-barreled vascularized fibula flaps.…”

“…7,9,11,[14][15][16]20,24,30,39,48,61 Usually a free vascularized fibula flap is used. 7,11,48,61 Autologous bony reconstruction of the pelvis using fibula has been described in the literature. 2,11,18,41,48 Yajima and Tamai reported 2 cases of pelvic reconstruction using double-strut vascularized fibula flaps.…”

“…Fibular grafting of the pelvic girdle after tumor resection has been previously described either as a free vascularized autograft or as nonvascularized allograft or autograft. 2,11,18,28,48 We report a new 3-stage Type 3 sacrectomy and reconstruction of the hemipelvis involving instrumented spinoiliac arthrodesis and pedicled fibula grafting in 2 patients. The first patient (Case 1), a 39-year-old woman who had a primary bone tumor of the sacrum (fibroblastic sarcoma) with a pelvis extension (Fig.…”