Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 4 Issue 6

Using Free Double Barrel Vascularized Fibular Grafting in Complex Nonunion with Extensive Bone Loss in Distal Humeral Fractures

Saab Mufleh Al Mestirihi1*, Yousef Marzouq Khair1, Ayman Mustafa Burghol2, Sherif Mamdouh AMR3, Sana’a Haddadin4 and Silvana De Giorgi5

1King Hussein Medical Center, Royal Medical Services, Amman, Jordan
2MD Orthopedic Surgeon, Upper Limb Department, Royal Medical Services, Amman, Jordan
3Professor, Orthopedic Consultant, Cairo University, Cairo, Egypt
4RN, Private Hospital, Amman, Jordan
5Professor, Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari, Italy

*Corresponding Author: Saab Mufleh Al Mestirihi, Hand and Upper Limb Department, Royal Medical Services, Amman, Jordan.

Received: May 03, 2021; Published: May 20, 2021

Abstract

Distal humeral fractures are not very common. 3% of these fractures may need further surgical management [22]. Nonunion of fractures of the distal humerus is a challenging issue for orthopedic surgeons. Management could be either by using non vascularized or vascularized bone grafts, or by using a double barrel vascularized graft from the fibula. In our study we used a double barrel vascularized fibular graft for treatment this kind of nonunion. We used this procedure with different ways of fixation (either using external fixation, k wires with screws, plates) in different patients. Double barrel vascularized fibular grafting is a good option for treatment of fracture nonunion with a gap of 6 cm or more. It adds stability to the medial and lateral columns and enhances bone healing at the fracture site.

Keywords: Double Barrel; Vascularized Fibular Graft; Non Union Humerus Fracture

References

  1. Jones NF., et al. “The "double barrel" free vascularized fibular bone graft”. Plastic and Reconstructive Surgery3 (1988): 378-385.
  2. Banic A and Hertel R. “Double vascularized fibulas for reconstruction of large tibial defects”. Journal of Reconstructive Microsurgery6 (1993): 421-428.
  3. Bähr W., et al. “Use of the "double barrel" free vascularized fibula in mandibular reconstruction”. Journal of Oral and Maxillofacial Surgery1 (1998): 38-44.
  4. Guerra MF., et al. “The partial double-barrel free vascularized fibular graft: a solution for long mandibular defects”. Plastic and Reconstructive Surgery5 (2000): 1902-1903.
  5. Amr SM., et al. “Reconstruction after resection of tumors around the knee: role of the free vascularized fibular graft”. Microsurgery5 (2000): 233-251.
  6. El-Gammal TA., et al. “Microsurgical reconstruction of lower limb bone defects following tumor resection using vascularized fibula osteoseptocutaneous flap”. Microsurgery5 (2002): 193-198.
  7. El-Gammal TA., et al. “Reconstruction of lower limb bone defects after sarcoma resection in children and adolescents using free vascularized fibular transfer”. Journal of Pediatric Orthopaedics B 12.4 (2003): 233-243.
  8. Bi ZG., et al. “Reconstruction of large limb bone defects with a double-barrel free vascularized fibular graft”. Chinese Medical Journal23 (2008): 2424-2428.
  9. Chu CH., et al. “Reconstruction of a massive femoral bone defect using a double-barreled free vascularized fibular bone graft after wide resection of femoral chondrosarcoma”. The Kaohsiung Journal of Medical Sciences10 (2009): 552-558.
  10. Tanaka K., et al. “Vascularized fibular graft for bone defects after wide resection of musculoskeletal tumors”. The Journal of Orthopaedic Science2 (2012): 156-162.
  11. Wieser K., et al. “Autologous double-barrel vascularized fibula bone graft for arthrodesis of the shoulder after tumor resection”. Archives of Orthopaedic and Trauma Surgery 9 (2013): 1219-1224.
  12. A Ali., et al. “Revision surgery for nonunion after early failure of fixationof fractures of the distal humerus”. Journal of Bone and Joint Surgery 87 (2005).
  13. Ackerman G and Jupiter JB. “Non-union of fractures of the distal end of the humerus”. Journal of Bone and Joint Surgery American 70 (1988): 75-83.
  14. Marko Bumbasirevic, Milan Stevanovic, Vesna Bumbasirevic, Aleksandar Lesic and Henry D.E.Atkinson (2014).
  15. Barnds B., et al. “Ipsilateral rotational double-barrel fibula autograft for limb salvage in a pediatric patient with lower extremity intramedullary osteosarcoma: A case report”. Microsurgery (2019).
  16. Wieser K., et al. “Autologous double-barrel vascularized fibula bone graft for arthrodesis of the shoulder after tumor resection”. Archives of Orthopaedic and Trauma Surgery9 (2013): 1219-1224.
  17. Chu CH., et al. “Reconstruction of a massive femoral bone defect using a double-barreled free vascularized fibular bone graft after wide resection of femoral chondrosarcoma”. The Kaohsiung Journal of Medical Sciences 10 (2009): 552-558.
  18. Cano-Luís P., et al. “Treatment of posttraumatic bone defects of the forearm with vascularized fibular grafts. Follow up after fourteen years”. Injury 2 (2018): S27-S35.
  19. Bi ZG., et al. “Reconstruction of large limb bone defects with a double-barrel free vascularized fibular graft”. Chinese Medical Journal 23 (2008): 2424-2428.
  20. Amr SM., et al. “Reconstruction after resection of tumors around the knee: role of the free vascularized fibular graft”. Microsurgery 5 (2000): 233-251.
  21. Beeres FJ., et al. “[Distal humerus fracture-extensile approaches]". Operative Orthopädie und Traumatologie2 (2017): 115-124.
  22. Robinson CM., et al. “Adult distal humeral metaphyseal fractures: epidemiology and results of treatment”. Journal of Orthopaedic Trauma1 (2003): 38-47.
  23. Zou H., et al. “Augmentation of pedicle screw fixation with percutaneous vertebroplasty with bone cement in treatment of senile osteoporotic vertebral compression fractures associated with spinal stenosis”. Journal Neck Pain 24 (2015): 93-99.

Citation

Citation: Saab Mufleh Al Mestirihi., et al. “Using Free Double Barrel Vascularized Fibular Grafting in Complex Nonunion with Extensive Bone Loss in Distal Humeral Fractures".Acta Scientific Orthopaedics 4.6 (2021): 72-77.

Copyright

Copyright: © 2021 Lewis Bridges and Stephen Pack. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is November 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US