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Free vascularised fibular grafting combined with a locking plate for massive bone defects in the lower limbs: A retrospective analysis of fibular hypertrophy in 18 cases
Injury, 06/26/2012

Gao YS et al. – Free vascularised fibular grafting (FVFG) could be a good choice for the reconstruction of massive bone defects when combined with a locking plate. Factors including gender, age distribution, site and length of bone defects, number of previous operations and infection do not impact the progress of fibular hypertrophy, which implies that intrinsic factors might play an important role in restoration.

Methods
  • Eighteen patients with a massive bone defect in a lower limb reconstructed by FVFG combined with a locking plate were retrospectively enrolled in the current study.
  • The degree of fibular hypertrophy was calculated based on the measurements from anteroposterior imaging at regular intervals of 3months, 6months, 1, 2 and 3years postoperatively.
  • Repeated measures analysis of variance was employed to evaluate and compare correlative factors including gender (male vs. female), age distribution (<30years vs. >30years), site (femur vs. tibia) and length of bone defect (6–10cm vs. >10cm), previous number of operations (once vs. more than twice) and concomitant infection (detected vs. non–detected).

Results
  • All defects could be successfully repaired by FVFG and bone union was achieved uneventfully.
  • The degree of fibular hypertrophy was 0.14%, 11.27%, 31.53%, 58.14% and 71.81% retrospectively at the five follow–up time points.
  • Statistical analysis revealed that the above–mentioned factors did not affect the progress of fibular hypertrophy.

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