Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2005

01-01-2005 | Original Article

Ankle Instability After Vascularized Fibular Harvest for Tumor Reconstruction

Authors: Saminathan S. Nathan, MD, Lee Hung-Yi, MD, Joseph J. Disa, MD, Edward Athanasian, MD, Patrick Boland, MD, Peter G. Cordeiro, MD, John H. Healey, MD

Published in: Annals of Surgical Oncology | Issue 1/2005

Login to get access

Abstract

Background

The vascularized fibular graft is an important tool in the reconstruction of defects caused by resections of orthopedic tumors. Children often undergo this form of reconstruction, but there is little information about the complications after vascularized fibular graft harvest in this age group.

Methods

We present a series of 32 patients who underwent this procedure to reconstruct an extremity in our institution. There were 12 children and 20 adults.

Results

The residual distal fibula was significantly longer in adults as compared with children (P < .048). Among children, 3 of 11 undergoing the procedure developed ankle instability, in distinction to adults, none of whom developed this complication (P < .041). This reflects a disruption of normal ankle function that develops in skeletally immature patients with a short residual fibula but not in patients with a longer residual fibula (P < .008). When the sum of patient age in years and residual fibula length in centimeters was less than 16, 3 of 6 patients developed deformity, in contrast to no deformity developing in the remaining 23 when the sum was >16 (P < .004). Adults were more likely to develop pain than instability.

Conclusions

Our series suggests that children with an age-length sum <16 should be considered for prophylactic tibiofibular synostosis creation.
Literature
1.
Weiland, AJ 1984Vascularized bone transfersInstr Course Lect3344660PubMed
2.
Taylor, GI, Miller, GD, Ham, FJ 1975The free vascularized bone graft. A clinical extension of microvascular techniquesPlast Reconstr Surg5553344CrossRefPubMed
3.
Hsu, RW, Wood, MB, Sim, FH, Chao, EY 1997Free vascularised fibular grafting for reconstruction after tumour resectionJ Bone Joint Surg Br793642PubMed
4.
Minami, A, Kasashima, T, Iwasaki, N, Kato, H, Kaneda, K 2000Vascularised fibular grafts. An experience of 102 patientsJ Bone Joint Surg Br8210225CrossRefPubMed
5.
Wada, T, Usui, M, Nagoya, S, Isu, K, Yamawaki, S, Ishii, S 2000Resection arthrodesis of the knee with a vascularised fibular graft. Medium- to long-term resultsJ Bone Joint Surg Br8248993PubMed
6.
Yuceturk, A, Tuncay, C, Isiklar, U, Tandogan, R 1998Vascularised bone graft applications in upper extremity problemsMicrosurgery181602PubMed
7.
Coghlan, BA, Townsend, PL 1993The morbidity of the free vascularised fibula flapBr J Plast Surg464669PubMed
8.
Yajima, H, Tamai, S, Mizumoto, S, Ono, H 1993Vascularised fibular grafts for reconstruction of the femurJ Bone Joint Surg Br751238PubMed
9.
Lee, EH, Goh, JC, Helm, R, Pho, RW 1990Donor site morbidity following resection of the fibulaJ Bone Joint Surg Br7212931PubMed
10.
Boer, HH, Wood, MB 1989Bone changes in the vascularised fibular graftJ Bone Joint Surg Br713748PubMed
11.
Weiland, AJ, Weiss, AP, Moore, JR, Tolo, VT 1990Vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibiaJ Bone Joint Surg Am7265462PubMed
12.
Pho, RW, Levack, B, Satku, K, Patradul, A 1985Free vascularised fibular graft in the treatment of congenital pseudarthrosis of the tibiaJ Bone Joint Surg Br676470PubMed
13.
Paluska, DJ, Blount, WP 1968Ankle valgus after the Grice subtalar stabilization: the late evaluation of a personal series with a modified technicClin Orthop5913746PubMed
14.
Hsu, LC, Yau, AC, O’Brien, JP, Hodgson, AR 1972Valgus deformity of the ankle resulting from fibular resection for a graft in subtalar fusion in childrenJ Bone Joint Surg Am5458594PubMed
15.
Lee, EH, Goh, JC, Helm, R, Pho, RW 1990Donor site morbidity following resection of the fibulaJ Bone Joint Surg Br7212931PubMed
16.
Coghlan, BA, Townsend, PL 1993The morbidity of the free vascularised fibula flapBr J Plast Surg464669PubMed
17.
Hsu, RW, Wood, MB, Sim, FH, Chao, EY 1997Free vascularised fibular grafting for reconstruction after tumour resectionJ Bone Joint Surg Br793642PubMed
18.
Moore, JR, Weiland, AJ, Daniel, RK 1983Use of free vascularized bone grafts in the treatment of bone tumorsClin Orthop1753744PubMed
19.
Han, CS, Wood, MB, Bishop, AT, Cooney, WP,III 1992Vascularized bone transferJ Bone Joint Surg Am7414419PubMed
20.
Hsu, RW, Wood, MB, Sim, FH, Chao, EY 1997Free vascularised fibular grafting for reconstruction after tumour resectionJ Bone Joint Surg Br793642PubMed
21.
Lee, EH, Goh, JC, Helm, R, Pho, RW 1990Donor site morbidity following resection of the fibulaJ Bone Joint Surg Br7212931PubMed
22.
Weiland, AJ, Weiss, AP, Moore, JR, Tolo, VT 1990Vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibiaJ Bone Joint Surg Am7265462PubMed
23.
Bodde, EW, de Visser, E, Duysens, JE, Hartman, EH 2003Donor-site morbidity after free vascularized autogenous fibular transfer: subjective and quantitative analysesPlast Reconstr Surg111223742PubMed
24.
Pacelli, LL, Gillard, J, McLoughlin, SW, Buehler, MJ 2003A biomechanical analysis of donor-site ankle instability following free fibular graft harvestJ Bone Joint Surg Am85597603PubMed
25.
Tang, CL, Mahoney, JL, McKee, MD, Richards, RR, Waddell, JP, Louie, B 1998Donor site morbidity following vascularized fibular graftingMicrosurgery183836PubMed
26.
Omokawa, S, Tamai, S, Takakura, Y, Yajima, H, Kawanishi, K 1996A long-term study of the donor-site ankle after vascularized fibula grafts in childrenMicrosurgery171626PubMed
27.
Babhulkar, SS, Pande, KC, Babhulkar, S 1995Ankle instability after fibular resectionJ Bone Joint Surg Br7725861PubMed
28.
Ganel, A, Yaffe, B 1990Ankle instability of the donor site following removal of vascularized fibula bone graftAnn Plast Surg2479PubMed
29.
Hsu, RW, Wood, MB, Sim, FH, Chao, EY 1997Free vascularised fibular grafting for reconstruction after tumour resectionJ Bone Joint Surg Br793642PubMed
30.
Moore, JR, Weiland, AJ, Daniel, RK 1983Use of free vascularized bone grafts in the treatment of bone tumorsClin Orthop1753744PubMed
31.
Han, CS, Wood, MB, Bishop, AT, Cooney, WP,III 1992Vascularized bone transferJ Bone Joint Surg Am7414419PubMed
32.
Lee, EH, Goh, JC, Helm, R, Pho, RW 1990Donor site morbidity following resection of the fibulaJ Bone Joint Surg Br7212931PubMed
33.
Coghlan, BA, Townsend, PL 1993The morbidity of the free vascularised fibula flapBr J Plast Surg464669PubMed
34.
Bodde, EW, Visser, E, Duysens, JE, Hartman, EH 2003Donor-site morbidity after free vascularized autogenous fibular transfer: subjective and quantitative analysesPlast Reconstr Surg111223742PubMed
35.
Babhulkar, SS, Pande, KC, Babhulkar, S 1995Ankle instability after fibular resectionJ Bone Joint Surg Br7725861PubMed
36.
Ganel, A, Yaffe, B 1990Ankle instability of the donor site following removal of vascularized fibula bone graftAnn Plast Surg2479PubMed
37.
Lee, EH, Goh, JC, Helm, R, Pho, RW 1990Donor site morbidity following resection of the fibulaJ Bone Joint Surg Br7212931PubMed
38.
Pacelli, LL, Gillard, J, McLoughlin, SW, Buehler, MJ 2003A biomechanical analysis of donor-site ankle instability following free fibular graft harvestJ Bone Joint Surg Am85597603PubMed
39.
Lee, EH, Goh, JC, Helm, R, Pho, RW 1990Donor site morbidity following resection of the fibulaJ Bone Joint Surg Br7212931PubMed
40.
Lee, EH, Goh, JC, Helm, R, Pho, RW 1990Donor site morbidity following resection of the fibulaJ Bone Joint Surg Br7212931PubMed
41.
Bodde, EW, Visser, E, Duysens, JE, Hartman, EH 2003Donor-site morbidity after free vascularized autogenous fibular transfer: subjective and quantitative analysesPlast Reconstr Surg111223742PubMed
42.
Lee, EH, Goh, JC, Helm, R, Pho, RW 1990Donor site morbidity following resection of the fibulaJ Bone Joint Surg Br7212931PubMed
Metadata
Title
Ankle Instability After Vascularized Fibular Harvest for Tumor Reconstruction
Authors
Saminathan S. Nathan, MD
Lee Hung-Yi, MD
Joseph J. Disa, MD
Edward Athanasian, MD
Patrick Boland, MD
Peter G. Cordeiro, MD
John H. Healey, MD
Publication date
01-01-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1007/s10434-004-1162-4

Other articles of this Issue 1/2005

Annals of Surgical Oncology 1/2005 Go to the issue

Original Article

Can Sentinel Lymph Node Biopsy Be Omitted in Patients With Favorable Breast Cancer Histology?

Original Article

The Indications for and the Prognostic Significance of Amputation as the Primary Surgical Procedure for Localized Soft Tissue Sarcoma of the Extremity

Original Article

Axillary Recurrence After a Negative Sentinel NodeBiopsy for Breast Cancer: Incidence and Clinical Significance

Editorial

“Axillary Recurrence After a Negative Sentinel Node Biopsy”: Editorial Comment

OriginalPaper

Forthcoming Reports

Editorial

Simplification of Breast Cancer Surgery