Assessment of vascularized fibular graft one year after reconstruction of the wrist after excision of a giant-cell tumour

We report a patient in whom the distal radius was resected for a giant cell tumour and the bone defect was replaced using a vascularized proximal fibu lar graft. The graft was viable and hypertrophied and normal callus formed on the distal radius. Due to chronic instability of the wrist the patient u nderwent revision arthrodesis 1 year after resection. Microscopic studies o f the epishyseal region of the fibula showed wide necrosis of the graft wit h active creeping substitution. Despite the good technical result of the va scularized fibular graft, the vascularization was incomplete in the proxima l epiphysis. We discuss possible reasons for this.