ABSTRACT
Limb-salvage surgery is the standard care for most malignant tumors affecting the
extremities, and a vascularized fibula transfer is probably the most popular microsurgical
option to reconstruct long-bone defects. Skeletal reconstruction after bone-tumor
resection involving the metepiphysis of a growing child can be successfully achieved
with a vascularized fibula graft incorporating the proximal physis and active growth
plate. Such a procedure has been utilized in 12 children under the age of 10 years
who had malignant bone tumors located in the upper limb (3 in the distal radius, 9
in the proximal humerus). The follow-up ranged between 4 years and 3 months. Ten grafts
were supplied by the anterior tibial artery, and two by the peroneal artery. The average
growth rate of the grafts based on the former artery has been more than 1 cm per year,
ranging between 0.75 and 1.33 cm. The authors describe a modified operative technique
and discuss the clinical results of the procedure which offers a satisfactory skeletal
reconstruction and prevents future limb-size discrepancy.
