Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Nov 18;14(1):291.
doi: 10.1186/s12957-016-1037-8.

Simultaneous reconstruction of the bone and vessels for complex femoral defect

Shimpei Miyamoto  1 , Masahide Fujiki  2 , Nokitaka Setsu  3 , Akira Kawai  3
Affiliations
Case Reports

Simultaneous reconstruction of the bone and vessels for complex femoral defect

Shimpei Miyamoto et al. World J Surg Oncol. .

Abstract

Background: Several methods have been reported for intercalary reconstruction of femoral defects. Of these, free vascularized fibula grafts (FVFG) are preferred because of their durability, bone-healing potential, and tolerance to infection. If the bone tumor invades the femoral vessels, simultaneous vascular reconstruction also becomes necessary and significant technical hurdles make limb salvage difficult.

Case presentation: We present a 10-year-old girl who underwent limb-sparing surgery for a distal femur osteosarcoma. The femoral defect was 15 cm long, and the femoral vessel defect was 10 cm long. The femur was reconstructed with bilateral FVFG, and the femoral vessels were reconstructed with saphenous vein grafts. The grafts survived without vascular compromise, and the affected limb was preserved successfully.

Conclusions: Combined use of bilateral FVFG and autologous vein grafts makes limb-sparing surgery for a large osteosarcoma of the femur possible.

Keywords: Bypass flap; Flow-through; Lateral circumflex femoral; Popliteal artery; Revascularization.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Preoperative contrast-enhanced magnetic resonance image. a Coronal view. b Axial view. Superficial femoral vessels (arrow)
Fig. 2
Fig. 2
Intraoperative appearance after reconstruction of the superficial femoral artery and vein (arrows). Left side is craniad
Fig. 3
Fig. 3
Intraoperative appearance after transfer of the bilateral FVFG. Left side is craniad. left fibula (black arrows), right fibula (white arrows), and monitoring flap of the right fibula (arrow heads)
Fig. 4
Fig. 4
Appearance after 1 year
Fig. 5
Fig. 5
Postoperative X-ray obtained after 20 months shows complete bone union
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Deijkers RL, Bloem RM, Kroon HM, Van Lent JB, Brand R, Taminiau AH. Epidiaphyseal versus other intercalary allografts for tumors of the lower limb. Clin Orthop Relat Res. 2005;439:151–60. doi: 10.1097/00003086-200510000-00029. - DOI - PubMed
    1. Yajima H, Tamai S, Mizumoto S, Ono H. Vascularised fibular grafts for reconstruction of the femur. J Bone Joint Surg Br. 1993;75:123–8. - PubMed
    1. Capanna R, Campanacci DA, Belot N, Beltrami G, Manfrini M, Innocenti M, Ceruso M. A new reconstructive technique for intercalary defects of long bones: the association of massive allograft with vascularized fibular autograft. Long-term results and comparison with alternative techniques. Orthop Clin North Am. 2007;38:51–60. doi: 10.1016/j.ocl.2006.10.008. - DOI - PubMed
    1. Tanzawa Y, Tsuchiya H, Yamamoto N, Sakayama K, Minato H, Tomita K. Histological examination of frozen autograft treated by liquid nitrogen removed 6 years after implantation. J Orthop Sci. 2008;13:259–64. doi: 10.1007/s00776-007-1222-2. - DOI - PubMed
    1. Ogura K, Miyamoto S, Sakuraba M, Fujiwara T, Chuman H, Kawai A. Intercalary reconstruction after wide resection of malignant bone tumors of the lower extremity using a composite graft with a devitalized autograft and a vascularized fibula. Sarcoma. 2015;2015:861575. doi: 10.1155/2015/861575. - DOI - PMC - PubMed

Publication types

MeSH terms