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Free vascularised fibular grafts in orthopaedics

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Abstract

Bony defects caused by trauma, tumors, infection or congenital anomalies can present a significant surgical challenge. Free vascularised fibular bone grafts (FVFGs) have proven to be extremely effective in managing larger defects (longer than 6 cm) where other conventional grafts have failed. FVFGs also have a role in the treatment of avascular necrosis (AVN) of the femoral head, failed spinal fusions and complex arthrodeses. Due to the fact that they have their own blood supply, FVFGs are effective even in cases where there is poor vascularity at the recipient site, such as in infection and following radiotherapy. This article discusses the versatility of the FVFG and its successful application to a variety of different pathologies. It also covers the applied anatomy, indications, operative techniques, complications and donor-site morbidity. Though technically challenging and demanding, the FVFG is an extremely useful salvage option and can facilitate limb reconstruction in the most complex of cases.

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Acknowledgments

This paper is supported by the grant No. 175095 Ministry of Science, Republic of Serbia.

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Authors and Affiliations

  1. School of Medicine, Clinic of Orthopaedic Surgery and Traumatology, Clinical Centre, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia

    Marko Bumbasirevic & Aleksandar Lesic

  2. Department of Orthopaedics, Program Director Joseph H. Boyes Hand Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    Milan Stevanovic

  3. School of Medicine, Institute for anesthesiology, Clinical Centre, University of Belgrade, Visegradska 26, Belgrade, Serbia

    Vesna Bumbasirevic

  4. Department of Trauma and Orthopaedics, North Middlesex University Hospital, Sterling Way, N18 1QX, UK

    Henry D. E. Atkinson

  5. London Sports Orthopaedics, London Bridge Hospital, London, UK

    Henry D. E. Atkinson

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  1. Marko Bumbasirevic
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  2. Milan Stevanovic
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  3. Vesna Bumbasirevic
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  4. Aleksandar Lesic
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  5. Henry D. E. Atkinson
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Correspondence to Marko Bumbasirevic.

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Bumbasirevic, M., Stevanovic, M., Bumbasirevic, V. et al. Free vascularised fibular grafts in orthopaedics. International Orthopaedics (SICOT) 38, 1277–1282 (2014). https://doi.org/10.1007/s00264-014-2281-6

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  • DOI: https://doi.org/10.1007/s00264-014-2281-6

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