![[Reconstruction of posttraumatic bony defects of the lower extremity: callotaxis or free vascularized fibula graft?].](/static/images/no-image.png)
Journal article
[Reconstruction of posttraumatic bony defects of the lower extremity: callotaxis or free vascularized fibula graft?].
- Platz A Klinik für Unfallchirurgie, Universitätsspital Zürich, Switzerland. andreas.platz@triemli.stzh.ch
- Werner CM
- Künzi W
- Trentz O
- Meyer VE
- 2005-01-06
Published in:
- Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V.... - 2004
Accidents, Traffic
Adolescent
Adult
Bony Callus
External Fixators
Female
Fibula
Fracture Fixation, Internal
Humans
Leg Injuries
Male
Middle Aged
Osteotomy
Surgical Flaps
Tibial Fractures
English
PURPOSE/BACKGROUND
Several methods have been established for the treatment of bony defects of the lower extremity. The purpose of this paper is to evaluate the use of a free vascularized fibula graft for these defects in comparison to callotaxis and segmental transport.
METHOD AND CLINICAL MATERIAL
Retrospective analysis of data from 32 patients treated between 1981 and 1999 at the University Hospital in Zurich, Switzerland with bony defects of the lower extremity.
RESULTS
The reconstruction of the bony defect was successful in 80 % with fibula graft, in 94 % with callotaxis and in 83 % with segmental transport. In the group with the fibula transplantation 2.6 re-interventions due to complications had to be performed, in the callotaxis group there were 3.6 and in the segmental transport group 5.2 surgical re-interventions. The time between primary intervention and full weight bearing was 16 months in the fibula transplantation group, 7.6 months in the callotaxis group and 10.7 months in the segmental transport group.
CONCLUSION
The results show that these three options can be used for different indications. Reconstruction can be planned according to the following rules: Segmental bony defects of the entire circumference of up to 5 cm are best treated by initial shortening followed by callus distraction. Bony defects from 5 to 12 cm are best treated by segmental transport while maintaining limb length. Defects > 12 cm are best treated by reconstruction with a vascularized free fibula graft.
Several methods have been established for the treatment of bony defects of the lower extremity. The purpose of this paper is to evaluate the use of a free vascularized fibula graft for these defects in comparison to callotaxis and segmental transport.
METHOD AND CLINICAL MATERIAL
Retrospective analysis of data from 32 patients treated between 1981 and 1999 at the University Hospital in Zurich, Switzerland with bony defects of the lower extremity.
RESULTS
The reconstruction of the bony defect was successful in 80 % with fibula graft, in 94 % with callotaxis and in 83 % with segmental transport. In the group with the fibula transplantation 2.6 re-interventions due to complications had to be performed, in the callotaxis group there were 3.6 and in the segmental transport group 5.2 surgical re-interventions. The time between primary intervention and full weight bearing was 16 months in the fibula transplantation group, 7.6 months in the callotaxis group and 10.7 months in the segmental transport group.
CONCLUSION
The results show that these three options can be used for different indications. Reconstruction can be planned according to the following rules: Segmental bony defects of the entire circumference of up to 5 cm are best treated by initial shortening followed by callus distraction. Bony defects from 5 to 12 cm are best treated by segmental transport while maintaining limb length. Defects > 12 cm are best treated by reconstruction with a vascularized free fibula graft.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1055/s-2004-830488
- PMID 15633085
- Persistent URL
- https://folia.unifr.ch/global/documents/32260
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