Abstract
Reconstruction of bony defects following resection of a sarcoma in the pediatric population can be challenging. When the tumor involves the epiphysis or there is not a safe margin of resection around the physis, the physis must be sacrificed, leading to eventual limb length inequalities. In the lower extremity a rotationplasty and an expandable prosthesis are options for reconstruction for tumors around the knee. In the upper extremity the proximal humerus is the most common location for malignant bone tumors and is responsible for 80% of humeral growth. In order to restore longitudinal growth, a free vascularized epiphyseal transfer (FVET) can be used to reconstruct the proximal humerus; however, this method is complicated by high rates of late fibula fracture. Recently, limb reconstruction with bulk structural allografts combined with free fibula flaps has been shown to reduce the risk of late structural failure of intercalary constructs. The use of a combined FVET and bulk-structural allograft offers a biological reconstructive option for the proximal humerus following en-bloc resection.
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Houdek, M.T., Wellings, E.P., Moran, S.L. (2022). Biological Reconstruction of the Proximal Humerus—III: Massive Allograft and Inlaid Free Vascular Fibula Epiphyseal Transfer. In: Özger, H., Sim, F.H., Puri, A., Eralp, L. (eds) Orthopedic Surgical Oncology For Bone Tumors . Springer, Cham. https://doi.org/10.1007/978-3-030-73327-8_40
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DOI: https://doi.org/10.1007/978-3-030-73327-8_40
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