gms | German Medical Science

Objectives: To explore the clinical application and effect of free vascularised fibular graft in the treatment of the infectious bony defect of upper limb.

Method: Form April 2009 to January 2015, the infectious bony defect of upper limb was treated by free vascularised fibular graft, 11 patients suffered such bony defect, including 2 humeral shafts, 6 radial backbones and 3 ulnar backbones. The infection was confirmed by sinus secretions preoperatively and bacterial culture at the lesion intraoperatively. After debridement, the length of bone defect was 5-20cm. 6 cases were suffered by emergency surgery, 5 cases by elective surgery, bone defects were repaired with single fibular graft for all patients. The blood supply of free vascularized tibia graft was monitored by the fibular flap in 9 cases. All the persons, fibulas were fixed by plates, the survival of the transplanted fibula and the healing of the bone were performed by imaging assessment postoperatively.

Results: All cases were followed up for 12 months to 39 months, with an average of 24.5 months. All transplanted fibulas survived and bone defect site achieved bone healing, the averaged length of transplanted fibulas was (6 ± 20) cm. The mean healing time of graft and bone graft was (5.5 ± 1.2) months, the supplyment of bone and reception of bone were no dysfunction, no infection recurrence and no stress fracture occurred for transplantation of fibulas.

Conclusion: It is conducive to treat the infectious bony defect of upper limb by free vascularised fibular graft, the bony defect of upper limb achieved high bone healing rate ,it is the ideal treatment.