Subtalar fusion with iliac bone free flap after a recalcitrant nonunion: Report of two cases.

Fractures of the calcaneus are associated with secondary osteoarthritis of the subtalar joint. In a persistent nonunion, vascularized bone flaps offer superior biologic and mechanical properties as well as accelerates joint fusion and decreases morbidity. In this report, we present results of the use of vascularized iliac bone free flap for treating subtalar failed fusions in two patients.

Vascularized periosteal transfer from the medial femoral condyle: is it compulsory to include the cortical bone?

Background: The corticoperiosteal flap from the medial femoral condyle has become the workhorse in the management of recalcitrant nonunions with vascularized periosteum. Inclusion of the outer condylar cortex has been advocated to avoid damaging the osteogenic capacity of the periosteum and is at present an ordinary technical step in the procedure.

Patients: A clinical prospective study was undertaken to evaluate the effectiveness of periosteal-only microvascular transfers from the medial femoral condyle associated with bone grafts in the treatment of recalcitrant nonunions.

Reconstruction of massive bone losses of the elbow with vascularized bone transfers.

Background: Massive bone loss of the elbow in young patients is a complex injury. A series of five cases of massive loss of the elbow joint reconstructed with single or double vascularized bone transfers is reported.

Methods: Five patients with nonacute massive bone loss of the distal humerus (two cases) or distal humerus and proximal ulna (three cases) were reconstructed with a single (two cases) or double (three cases) microvascular vascularized bone transfer from the iliac crest, the fibula, or the scapula.

Infrapopliteal lower extremity replantation.

Background: Replantation surgery in lower extremity amputations continues to be controversial. Overall results have been considered poor and the procedure is usually discouraged. It is the opinion of the authors that infrapopliteal replantation may be indicated.

CD3+-mediated rejection and C4d deposition in two composite tissue (bilateral hand) allograft recipients after induction with alemtuzumab.

Background: New therapies are being introduced in reconstructive transplant surgery to enhance composite tissue allograft survival.

Methods: Alemtuzumab was used in two bilateral hand allograft recipients to cause lymphocyte depletion.

Results: Although profound leukopenia and lymphopenia developed, several episodes of acute rejection occurred both in the early and late posttransplant period.

Scoliosis after median sternotomy in children with congenital heart disease.

Study Design: A retrospective review of spinal deformity in patients with congenital heart disease surgically treated through a median sternotomy before the age of 8 years. Assessment was done on chest roentgenograms at skeletal maturity.

Objectives: To determine if patients surgically treated through a median sternotomy present a higher prevalence of spinal deformity.