Vascularized Fibula Graft To The Upper Extremity

From 1979 to 1995 in our clinic, vascularized fibula grafting was performed in 19 patients with intractable diseases in the upper extremity. There were 12 men and 7 women. Ages at operation ranged from 3 to 67 years, with an average of 37.4 years. Three patients had traumatic bone defects, four had post-traumatic nonunions, two had congenital pseudoarthroses, seven had defects after tumor resection, and three had other lesions. Reconstructed sites were the humerus in two patients, the radius in 13, the ulna in two, both radius and ulna in one, and the metacarpal and phalangeal bones in one. The length of the bone defect ranged from 3 to 18 cm (mean: 8.6 cm). The follow-up periods ranged from 10 to 204 months, with an average of 74 months. No patients required additional bone grafts. The mean period required to obtain radiographic bone union was 4.5 months. There were no cases with fractures of the grafted bone, but malunion occurred in four cases.