One-Bone Forearm Formation Using Vascularized Fibula Graft for Massive Bone Defect of the Forearm with Infection: Case Report

Kouichi Arai; Satoshi Toh; Masahiro Yasumura; Yoshitaka Okamoto; Seiko Harata

doi:10.1055/s-2001-14345

Journal of Reconstructive Microsurgery, Inhaltsverzeichnis

J Reconstr Microsurg 2001; 17(3): 151-156
DOI: 10.1055/s-2001-14345

One-Bone Forearm Formation Using Vascularized Fibula Graft for Massive Bone Defect of the Forearm with Infection: Case Report

Kouichi Arai¹ , Satoshi Toh¹ , Masahiro Yasumura¹ , Yoshitaka Okamoto² , Seiko Harata¹

¹Department of Orthopaedic Surgery, Hirosaki University School of Medicine; Aomori, Japan and
²Department of Orthopaedic Surgery, Towada Municipal Hospital, Aomori, Japan

Abstract

ABSTRACT

Massive long-bone defects of greater than 6 cm are difficult to treat with conventional bone grafts, and other methods are sometimes recommended, such as vascularized bone grafts or bone transport using the Ilizarov external fixator. The combination of local infection with a massive bone defect exacerbates the problem, and provides an even more negative prognosis. The authors treated a large bone defect of the forearm with local infection, using a one-bone forearm formation with a large vascularized fibula graft. They attached an adequate amount of muscle fascia to the vascularized fibula, which was useful not only for coverage of the skin defect, but also for treatment of the local infection. Twenty months after surgery, elbow and hand functions were maintained, and the patient had no disturbance of hand function in daily activities, although rotation of the forearm was sacrificed.

KEYWORD

One-bone forearm - vascularized fibula graft - massive bone defect - local infection - forearm

Volltext

Referenzen

REFERENCES

1 Enneking W F, Eady J L, Burchardt H. Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg . 1980; 62A 1039-1058
2 Stevanovic M, Gutow A P, Sharpe F. The management of bone defects of the forearm after trauma. Hand Clinics . 1999; 15 299-318
3 Hey-Groves E W. Modern Methods of Treating Fractures, 2^nd ed. Bristol: John Wright & Sons, . 1921: 320
4 Greenwood H H. Reconstruction of forearm after loss of the radius. Br J Surg . 1932; 20 58-60
5 Watson-Jones R. Reconstruction of the forearm after loss of the radius. Br J Surg . 1934; 22 23-26
6 Reid R L, Baker G I. The single-bone forearm: a reconstructive technique. Hand . 1973; 5 214-219
7 Castle M E. One-bone forearm. J Bone Joint Surg . 1974; 56A 1223-1227
8 Riordan D C, Mills E H, Alldredge R H. Congenital absence of the ulna. Proceedings of the American Society for Surgery of the Hand. J Bone Joint Surg . 1961; 43A 614
9 Spinner M, Freundlich B D, Abeles E D. Management of moderate longitudinal arrest of development of the ulna. Clin Orthop . 1970; 69 199-202
10 Allieu Y, Reckendorf G M, Chammas M, Gomis R. Congenital pseudarthrosis of both forearm bones: long-term results of two cases managed by free vascularized fibular graft. J Hand Surg . 1999; 24A 604-608
11 Dell P C, Sheppard J E. Vascularized bone grafts in the treatment of infected forearm nonunions. J Hand Surg . 1984; 9A 653-658
12 Peterson II A C, Maki S, Wood M B. Clinical results of the one-bone forearm. J Hand Surg . 1995; 20A 609-618
13 Vitale C C. Reconstructive surgery for defects in the shaft of the ulna in children. J Bone Joint Surg . 1952; 34A 804-809
14 Chen F, Culp R W, Schneider L H. Revision of the ununited one-bone forearm. J Hand Surg . 1998; 23A 1091-1096
15 Ger R. Muscle transposition for treatment and prevention of chronic posttraumatic osteomyelitis of the tibia. J Bone Joint Surg . 1977; 59A 784-791
16 Russell R C, Graham D R, Feller A M. Experimental evaluation of the antibiotic carrying capacity of a muscle flap into a fibrotic cavity. Plast Reconstr Surg . 1988; 81 162-168
17 Tong C WC, Hung L K, Cheng J CY. Lengthening of a one-bone forearm: a sequel of neonatal osteomyelitis. J Hand Surg . 1998; 23B 453-456