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European Journal of Orthopaedic Surgery & Traumatology

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01-10-2017 | Original Article • ELBOW - FRACTURES

Free non-vascularized fibular graft for treatment of large bone defect around the elbow in pediatric patients

Authors: Kamolporn Kaewpornsawan, Perajit Eamsobhana

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2017

Abstract

Background

Large bone defect is a challenging problem in orthopedics practice. Several methods are available for bridging of these bone defects, including cancellous bone graft, free vascularized fibula graft, and bone transport with external ring fixator. The aim of this study was to describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint.

Objective

To describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint.

Method

This retrospective review was conducted in patients with large bone defect with bony gap >7 cm. Time to union, range of motion, complications, Mayo Elbow Performance Score, and Foot and Ankle Disability Index (FADI) were recorded.

Result

The large bone defects included in this study were managed by free non-vascularized fibular strut bone grafts (FNVFG) that were harvested subperiosteally. Nine patients with a mean age of 11 years (range: 6–17) underwent this procedure. Nine grafts (100%) united at both ends within an average of 9 weeks (range: 8–14). Mean length of defect was 9.3 cm (range: 8–13 cm). Mean postoperative Mayo Elbow Performance Score was significantly higher than the mean preoperative score (98.33 vs. 64.44, respectively; p < 0.001). Three fibulae were observed for hypertrophy. Mean Foot and Ankle Disability Index score was 100 both preoperatively and postoperatively in all patients.

Conclusion

Free non-vascularized fibular graft is a simple procedure and a reliable method for bridging large bone defect or loss caused by open fracture and/or infection around the elbow in pediatric patients.

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Title: Free non-vascularized fibular graft for treatment of large bone defect around the elbow in pediatric patients
Authors: Kamolporn Kaewpornsawan
Perajit Eamsobhana
Publication date: 01-10-2017
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2017
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-017-1955-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Free non-vascularized fibular graft for treatment of large bone defect around the elbow in pediatric patients

Abstract

Background

Objective

Method

Result

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Method

Result

Conclusion

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