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Free non-vascularized fibular graft for treatment of large bone defect around the elbow in pediatric patients

  • Original Article • ELBOW - FRACTURES
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Large bone defect is a challenging problem in orthopedics practice. Several methods are available for bridging of these bone defects, including cancellous bone graft, free vascularized fibula graft, and bone transport with external ring fixator. The aim of this study was to describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint.

Objective

To describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint.

Method

This retrospective review was conducted in patients with large bone defect with bony gap >7 cm. Time to union, range of motion, complications, Mayo Elbow Performance Score, and Foot and Ankle Disability Index (FADI) were recorded.

Result

The large bone defects included in this study were managed by free non-vascularized fibular strut bone grafts (FNVFG) that were harvested subperiosteally. Nine patients with a mean age of 11 years (range: 6–17) underwent this procedure. Nine grafts (100%) united at both ends within an average of 9 weeks (range: 8–14). Mean length of defect was 9.3 cm (range: 8–13 cm). Mean postoperative Mayo Elbow Performance Score was significantly higher than the mean preoperative score (98.33 vs. 64.44, respectively; p < 0.001). Three fibulae were observed for hypertrophy. Mean Foot and Ankle Disability Index score was 100 both preoperatively and postoperatively in all patients.

Conclusion

Free non-vascularized fibular graft is a simple procedure and a reliable method for bridging large bone defect or loss caused by open fracture and/or infection around the elbow in pediatric patients.

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Acknowledgements

The authors of this study gratefully acknowledge Suchitphon Chanchoo for assistance with data collection and statistical analysis.

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Authors and Affiliations

  1. Department of Orthopedics Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglung Road Bangkoknoi, Bangkok, Thailand

    Kamolporn Kaewpornsawan & Perajit Eamsobhana

Authors
  1. Kamolporn Kaewpornsawan
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  2. Perajit Eamsobhana
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Correspondence to Perajit Eamsobhana.

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The authors hereby declare no personal or professional conflicts of interest regarding any aspect of this study.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Kaewpornsawan, K., Eamsobhana, P. Free non-vascularized fibular graft for treatment of large bone defect around the elbow in pediatric patients. Eur J Orthop Surg Traumatol 27, 895–900 (2017). https://doi.org/10.1007/s00590-017-1955-3

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  • DOI: https://doi.org/10.1007/s00590-017-1955-3

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