TREATMENT OF A COMPLICATED FEMORAL SHAFT NON-UNION USING VASCULARIZED FIBULAR GRAFT - CLINICAL CASE

D. Vilcioiu; I. Cristescu; A. Ursache; D. Zamfirescu; F. Safta; A. Stoian; I. Lascar

doi:10.33695/jss.v3i4.79

D. Vilcioiu The Department of Orthopedics and Traumatology, The Clinical Emergency Hospital of Bucharest, Romania
I. Cristescu The Department of Orthopedics and Traumatology, The Clinical Emergency Hospital of Bucharest, Romania
A. Ursache The Department of Orthopedics and Traumatology, The Clinical Emergency Hospital of Bucharest, Romania
D. Zamfirescu The Department of Plastic Surgery and Reconstructive Microsurgery, The Clinical Emergency Hospital of Bucharest, Romania
F. Safta The Department of Orthopedics and Traumatology, The Clinical Emergency Hospital of Bucharest, Romania
A. Stoian The Department of Plastic Surgery and Reconstructive Microsurgery, The Clinical Emergency Hospital of Bucharest, Romania
I. Lascar The Department of Plastic Surgery and Reconstructive Microsurgery, The Clinical Emergency Hospital of Bucharest, Romania

DOI: https://doi.org/10.33695/jss.v3i4.79

Keywords: vascularized fibular graft, reconstructive microsurgery, femoral non-union

Abstract

Free vascularized bone grafts were found to be very effective in segmental bone defect resulted after trauma or wide tumor resection. We present a complex case of a femoral shaft non-union, which was initially treated in other service. After two surgical interventions, both complicated with implant failure after bone non-union, the segmental bone loss was treated in our clinic using free vascularized bone graft. This method was found to be really efficient and the patient was able to walk again after a good rehabilitation program in less than 6 months. Our experience with microvascular transfer of fibular graft has shown that massive autogenous bone grafting with an intact vascular pedicle accelerates the time for bone healing and improves the rehabilitation program. Non-union in long bones after multiple surgical interventions will lead to implant failure and bone loss. The technique has proven reliable in the reconstruction of the bone defect of greater than 6 to 8 cm following defects existing in a fibrotic, avascular bed. Donor site morbidity was negligible. We managed to treat a complicated case of a femoral shaft non-union in an orthoplastic manner using both techniques and principles. Our data suggests that vascularized bone grafts represent a valuable procedure for reconstruction of large segmental bone loss.