The reconstruction of large bone defects in the upper limb

• Published in: Injury Vol. 44; no. 3; pp. 313 - 317
• Main Authors: Gan, Aaron W.T, Puhaindran, Mark E, Pho, Robert W.H
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.03.2013
• Subjects: Bone graft; Bone Transplantation; Bone transport; Cost-Benefit Analysis; Fibula - transplantation; Fracture Healing; Free Tissue Flaps - blood supply; Free vascularised fibula; Humans; Humeral Fractures - physiopathology; Humeral Fractures - surgery; Microsurgery; Orthopedics; Reconstructive Surgical Procedures; Recovery of Function; Retrospective Studies; Treatment Outcome; Ulna Fractures - physiopathology; Ulna Fractures - surgery; Upper Extremity - injuries; Upper Extremity - physiopathology; Upper Extremity - surgery; Upper limb bone defects; Wounds and Injuries - physiopathology; Wounds and Injuries - surgery; Bone transport; Bone graft; Free vascularised fibula; Upper limb bone defects
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2013.01.014

Abstract Large bone defects in the upper limb pose many challenges in reconstructive surgery. Conventional and innovative methods have been described, employing the use of microsurgical and non-microsurgical techniques to overcome both bony and soft tissue defects. This article reviews the success and pitfalls of different techniques of reconstruction of large bone defects in the upper limb, including microsurgical transfer of the free vascularised fibula graft as a diaphyseal bone replacement and as a hemivascularised joint transplant, and non-microsurgical options using conventional bone grafting, the induced membrane technique and the role of callotatic distraction-lengthening procedures.