AI Article Synopsis
- Sixteen patients with large bone defects in their extremities were treated using vascularized grafts from the iliac crest; 13 had open defects while 3 had closed ones.
- The average bone defect size was 7 cm, with healing times varying from 8.8 months for lower extremities to 4 months for upper extremities; some patients faced complications that led to modifications in the graft transfer technique.
- Six patients received an osteomuscular graft with a separate skin graft, and specific techniques like double microvascular anastomosis were employed for transfers to the distal forearm.
Article Abstract
We treated sixteen patients, all of whom had a large segmental defect of bone in an extremity, with transfer of a vascularized graft of the iliac crest. Thirteen patients had an open defect that required an osteomuscular or osteocutaneous graft; the other three had a closed segmental osseous defect and the graft of the iliac crest was transferred without soft tissue. The average length of the osseous defect was seven centimeters. For the defects of the lower extremity, the average time to osseous union was 8.8 months. For the defects of the upper extremity, it was four months. Three patients had delayed union due to difficulty in positioning the graft on the tibia and maintaining circulation to the overlying skin; this led us to modify our method of transfer. In six patients, we used an osteomuscular graft and a separate skin graft instead of the osteocutaneous flap. When performing the transfers to the tibia, we tried to place the graft in the coronal plane against the fibula for better alignment and stability. For the transfers to the distal part of the forearm, we did a double microvascular anastomosis.
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