Vascularized proximal fibular epiphyseal transfer: Two cases

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Abstract

Vascularized proximal fibular epiphyseal transfer in children enables reconstruction of long-bone epiphyseal defect, while conserving axial growth potential. This technique was applied in two children for diaphyseal-epiphyseal reconstruction of the proximal humerus and distal radius respectively, using a graft vascularized only by the anterior tibial artery. There were no major complications during harvesting. Both cases showed transplant growth, of a mean 0.5. cm/year. Joint function in the proximal humerus reconstruction was satisfactory, with functional range of motion. In the distal radius reconstruction, range of motion was almost zero; insufficient transplant growth induced radial club hand, requiring partial correction by progressive lengthening using an external fixator. In case of severe bone loss, fibular epiphyseal-diaphyseal graft vascularized only by the anterior tibial artery is a feasible attitude. © 2012 Elsevier Masson SAS.

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Medrykowski, F., Barbary, S., Gibert, N., Lascombes, P., & Dautel, G. (2012). Vascularized proximal fibular epiphyseal transfer: Two cases. Orthopaedics and Traumatology: Surgery and Research, 98(6), 728–732. https://doi.org/10.1016/j.otsr.2012.05.009

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