Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Vascularized bone grafts for post-traumatic defects in the upper extremity

  • Petrella, Giovanna (Department of Hand Surgery and Microsurgery, University Hospital Policlinico of Modena) ;
  • Tosi, Daniele (Department of Hand Surgery and Microsurgery, University Hospital Policlinico of Modena) ;
  • Pantaleoni, Filippo (Department of Hand Surgery and Microsurgery, University Hospital Policlinico of Modena) ;
  • Adani, Roberto (Department of Hand Surgery and Microsurgery, University Hospital Policlinico of Modena)
  • Received : 2020.05.19
  • Accepted : 2020.09.29
  • Published : 2021.01.15
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Abstract

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5-6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

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References

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