Published in:
01-08-2020 | Original Paper
Treatment of tibial intercalary defects secondary to tumour with modified fibular flap technique
Published in: European Journal of Plastic Surgery | Issue 4/2020
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Background
The purpose of this study was to assess the effectiveness of a modified fibular flap technique in tibial intercalary defects secondary to tumour.
Methods
The study included 13 patients diagnosed with osteosarcoma or Ewing sarcoma in the tibia diaphysis between January 2010 and November 2017. The intercalary defect formed in the tibia diaphyseal region was repaired with the combined method of fibular sliding and autoclaved autogenous bone graft. Functional evaluations were made using the Musculoskeletal Tumour Society (MSTS) scoring system.
Results
The patients comprised 8 females and 5 males with a mean age of 10 years (range, 7–14 years). The size of the intercalary defect formed was mean 13.6 cm (range, 11–17 cm). The mean operating time was 141 min (range, 131–162 min). Intraoperative blood loss was mean 400 cc (range, 300–500). These 13 patients were followed up for mean 58 months (range, 14–110 months). No infection developed in any patient. The overall mean time for the bone union was 5.4 months (range, 4.4–7.6 months) at the fibula–host junction and 11.6 months (range, 8–14 months) at the allograft–host junction.
Conclusions
This technique appears to have significant advantages as an alternative method for the repair of intercalary defects in the tibia. These advantages include that it does not have a long operating time, does not create excessive tissue damage, and does not cause severe complications such as infection.
Level of evidence: Level IV, therapeutic study.