Plastic and reconstructive surgery
-
Plast. Reconstr. Surg. · Jan 2010
Fibula free flap reconstruction of the pelvis in children after limb-sparing internal hemipelvectomy for bone sarcoma.
Neoadjuvant chemotherapy has improved the treatment of bone sarcomas, making wide resection with limb salvage frequently possible. However, resection of iliac tumors without reconstruction causes pelvic instability and significant leg length discrepancy. Free vascularized bone autograft reconstruction represents a potentially optimal method for iliac reconstruction because of the faster healing time and rapid hypertrophy of the grafts. Furthermore, living incorporated autograft may be more durable in the setting of radiation therapy or chemotherapy. The purpose of this study was to characterize the successful reconstruction of the pelvis in children using a triangular double-barrel fibula free flap following limb-sparing internal hemipelvectomy for sarcoma. ⋯ An "A-frame" double-barrel fibula free flap can be used effectively for reconstruction of the type I internal hemipelvectomy defect. It permits a return to ambulation and minimizes leg length discrepancy and other complications, which may be critical in the immature pediatric skeleton.