Vascularised bone grafting for fibrous dysplasia of the upper limb

We describe our experience with vascularised bone grafting for the treatmen t of fibrous dysplasia of the upper limb in eight patients, five men and th ree women, aged between 17 and 36 years. The site was in the humerus in six and the radius in two. Persistent pain, progression of the lesion and path ological fracture with delayed union were the indications for surgical inte rvention. We used a vascularised fibular graft after curettage of the lesion. Functio n and radiological progress were serially monitored. Early radiological uni on of the graft occurred at periods ranging from 8 to 14 weeks. The mean pe riod for reconstitution of the diameter of the bone was 14 months (12 to 18 ) predominantly through inductive formation of bone around the vascularised graft, which was a prominent feature in all patients. There were no recurr ences and none of the grafts sustained a fracture or failed to unite. After operation function was excellent in three patients and good in five, Vascu larised bone grafts provide a safe and reliable means of ensuring good cont inuity of bone with little risk of recurrence and failure.