New Fibular Strut Graft Technique to Minimize Donor Site Complications

Sung-Taek Jung; Buyng-Soo Kim; Zeng-Feng Xin; Eun-Sun Moon; Keun-Bae Lee

doi:10.4055/jkoa.2007.42.3.285

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Jung, Kim, Xin, Moon, and Lee: New Fibular Strut Graft Technique to Minimize Donor Site Complications

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(3): 285-290.

Published online: 30 June 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.3.285

New Fibular Strut Graft Technique to Minimize Donor Site Complications

Sung-Taek Jung, M.D., Buyng-Soo Kim, M.D., Zeng-Feng Xin, M.D., Eun-Sun Moon, M.D., Keun-Bae Lee, M.D.

Department of Orthopedics, Chonnam National University Hospital, Gwangju, Korea.

Address reprint requests to Sung-Taek Jung, M.D. Department of Orthopaedic Surgery, Chonnam University College of Medicine, 5, Hak 1-dong, Dong-gu, Gwangju 501-746, Korea. Tel: +82.62-227-1640, Fax: +82.62-225-7794, stjung@chonnam.ac.kr

Abstract

Purpose

To evaluate the effectiveness of a periosteal sleeve preserced fibular strut graft for the minimization of donor site complications.

Materials and Methods

Between September 1998 and March 2005, 20 patients who were followed for more than 12 months after the fibular sturt graft for a bone defect using a periosteal sleeve preservation technique were evaluated. The mean age was 13.3 years (range, 2-29 years) and the mean follow-up period was 16.2 months (range, 12-36 months).

Results

The mean time for the union of the primary disease was 3.3 months (range, 2-6 months) and for regeneration of the donor site was 9.1 weeks (range, 4-12 weeks) in 13 cases. Partial regeneration developed in 6 cases and there was no regeneration in 1 case. There were 2 cases of donor site complications.

Conclusion

The new fibular strut graft technique is very effective method for reconstruction of a bone defect with a minimization of the donor site complications particularly in children.

Keywords: Fibular graft, Periosteal sleeve preservation, Donor site complications

Figures and Tables

Fig. 1

(A) A longitudinal incision was made on the fibular and its periosteum. (B) The fibular was harvested using a periosteal preservation technique. (C) Bone defect of the donor site was filled with an allochip graft or calcium sulfate. (D) The periosteum was sutured.

Fig. 2

A) Preoperative radiograph of a 6-year-old boy show a simple bone cyst on the proximal femur. (B) Immediate postoperative radiograph show a bone defect of the primary disease filled with fibula. A new defect of donated fibular was filled with an allochip graft and repaired using a periosteal preservation technique. (C) After 3 months, the primary disease was healed and the fibular had completely regenerated.

Table 1

Summary of Cases

^*M, male; F, female; ^†ABC, aneurysmal bone cyst; SBC, simple bone cyst; FD, fibrous dysplasia; OFD, osteofibrous dysplasia; OSA, osteosarcoma; ^‡Regeneration index, time to regeneration (weeks)/portion of regeneration (%, length of taken fibula/length of fibula).

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