[Limb salvage surgery for wrist in bone tumor by using free vascularised fibular graft with fibular head or simple fibular graft].

OBJECTIVE: To compare the long-term results of vascularised fibular graft and simple autologous fibular graft for reconstruction of wrist after distal bone tumor resection. METHODS: From January 1979 to September 2002, 15 patients with wrist defects due to distal bone tumor resection were treated with vascularised fibular graft or simple autologous fibular graft and followed up 1 year. The results were graded with Enneking's system and evaluated radiographically according to the "International Symposium on Limb Salvage". The grade system included limb function, radiological examination and the function of ankle. RESULTS: The limb function of 8 patients with vascularised fibular graft restored to 80% of normal function and the bone union was achieved within 6 months. The limb function of 6 patients with simple autologous fibular graft restored to 67% of normal function. The bony union was achieved within 6 months in 4 cases with the bone graft less than 5 cm and in the 13th and 16th months in 2 cases with the bone graft more than 12 cm. CONCLUSION: It is suitable to use the head of fibular bone as a substitute for the distal radius. The healing of vascularised fibular graft is very quick and haven't the bone resorption. So in the procedure for reconstruction and limb salvage after bone tumor resection of distal radius, the free vascularised fibular graft with fibular head is an ideal substitute.