Biological Reconstruction of the Forearm, Wrist, and Hand—I: Free Vascular Fibula

Abstract

The primary goal in upper extremity limb salvage procedures is to preserve the hand function whereas in the lower extremities, weight-bearing characteristic of the reconstruction method is more important. The importance and difficulty of both functional and oncologically safe limb salvage in the setting of a distal upper extremity tumor cannot be overemphasized since the anatomical structures involved or at risk are those, which provide the manual dexterity essential for improved quality-of-life. Restoring the original two-bone anatomy, as opposed to the one-bone forearm techniques, might be considered the ideal treatment strategy for tumor-related forearm diaphyseal defects. Long intercalary defects of the forearm bones are best managed with the transfer of free vascular fibula grafts. This chapter describes multidisciplinary treatment followed by limb salvage with biological reconstruction using free vascular fibular graft in a 15-year-old female patient with Ewing’s sarcoma of the radius diaphysis.