Reconstruction of distal fibula with osteoarticular allograft after tumor resection

• Published in: Foot and ankle surgery Vol. 19; no. 1; pp. 31 - 35
• Main Authors: Jamshidi, Khodamorad, MD, Mazhar, Farid Najd, MD, Masdari, Zahra, MD
• Format: Journal Article
• Language: English
• Published: France Elsevier Ltd 01.03.2013
• Subjects: Adolescent; Adult; Ankle Joint - surgery; Bone Neoplasms - diagnosis; Bone Neoplasms - surgery; Child; Female; Fibula; Fibula - surgery; Humans; Male; Orthopedics; Reconstruction; Reconstructive Surgical Procedures - methods; Resection; Transplantation, Homologous; Tumor; Young Adult; Reconstruction; Tumor; Fibula; Resection
• ISSN: 1268-7731; 1460-9584
• DOI: 10.1016/j.fas.2012.09.001

Abstract Background Involvement of distal fibula by benign aggressive and malignant tumors usually necessitates resection of the involved segment of fibula. Numerous techniques have been proposed to reconstruct the ankle joint after this procedure, which can result in complications. We introduce reconstruction of ankle joint by fibular osteoarticular allograft. Methods Reconstruction of the distal fibula after wide resection of tumor was carried out in four patients. There were two cases of Ewing sarcoma, one case of osteosarcoma and one giant cell tumor. After wide resection of tumor, we reconstructed the lateral side of the ankle joint by osteoarticular fibular allograft, which was applied and internally fixed with semitubular plate and screws. In the follow up period, we did assessment of complications, pain and ankle joint instability. Results The mean age of our patients was 24.2 years (12–31). The mean follow-up was 3.2 years (1.5–6.7). In follow up visits there were no signs of infection or wound healing problems. Union was achieved in all patients. Conclusion In cases of benign aggressive and malignant tumors involving the distal fibula, we can recommend resection of the distal fibula and reconstruction of the ankle with osteoarticular allograft of the distal fibula. Level of evidence Case series level IV.