RECONSTRUCTION OF TIBIA BY IPSILATERAL VASCULARIZED FIBULA AND ALLOGRAFT - 12 CASES WITH MALIGNANT BONE-TUMORS

We treated 12 patients with a primary sarcoma of the tibia by resectio n and centralization of the ipsilateral vascularized fibula with prese rved vascularization. The reconstruction was combined with an allograf t. The median bone defect after tumor resection was 14(8-24) cm. The a nastomosis between the allograft and the recipient bone was stabilized by a plate or screws or Kirschner-wires. To reconstruct the soft tiss ues, 8 patients underwent a gastrocnemius plasty and 2 patients a free vascularized flap of the latissimus dorsi muscle. The mean follow-up period was 2.5 (2-3.5) years. 2 years after implantation, union greate r than or equal to 75% of the anastomosis area was noted in 10 patient s. A deformity or fracture of the distal junction occurred in 7 patien ts with a screw or Kirschner-wire fixation. Neither deformity nor frac ture developed in the 5 patients with plate-fixation.