COMPARISON OF VASCULARIZED ILIAC CREST AND VASCULARIZED FIBULA TRANSFER FOR RECONSTRUCTION OF SEGMENTAL AND PARTIAL BONE DEFECTS IN LONG BONES OF THE LOWER-EXTREMITY

The results and complications of lower extremity bone reconstruction u sing microvascular fibula transfer were retrospectively compared with reconstruction using microvascular iliac crest transfer, Seventeen pat ients matched as much as possible in regard to location of defect (fem ur, tibia, ankle) and aetiology (traumatic defect, osteomyelitis) were studied in each group. Data collected included number of prior operat ive procedures, length of bony defect, presence or absence of associat ed soft tissue loss, the final clinical and radiographic result, techn ique of bone immobilisation and duration to union, complications inclu ding patency of microvascular anastomoses (if known) and nature and nu mber of additional operative procedures. The outcome of this study sug gests that, for reconstruction of the femur or tibia bridging a defect greater than 10 cms, fibula transfer yielded a satisfactory outcome. For defects less than 10 cms resulting from debridement for osteomyeli tis, iliac crest transfer yielded a more favourable result. Moreover, the iliac crest appeared to be more optimal than the fibula for recons truction about the ankle regardless of aetiology. (C) 1996 Wiley-Liss, Inc.