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Augmentation of Bone Allograft with Vascularized Medial Femoral Condyle Periosteal Flap in Radius Reconstruction

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Clinical Scenarios in Reconstructive Microsurgery

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Abstract

Giant cell tumors of the distal radius can be aggressive, resulting in destruction of local anatomy and the need for wide resection. Reconstruction of the distal radius using allograft bone augmented with a vascularized medial femoral condyle (MFC) periosteal flap improves chances for bony healing while reducing the donor-site morbidity seen with vascularized bone flaps. In this chapter, a patient who required en bloc resection of a giant cell tumor of the distal radius was reconstructed with a wrist arthrodesis using an allograft distal radius in combination with a vascularized medial femoral condyle periosteal graft. This patient achieved good bony healing with satisfactory functional results, and details of our operative technique and helpful strategies for success are provided.

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References

  • Bakri K, Shin AY, Moran SL. The vascularized medial femoral corticoperiosteal flap for reconstruction of bony defects within the upper and lower extremities. Semin Plast Surg. 2008;22:228–33.

    Article  Google Scholar 

  • Campanacci DA, Totti F, Puccini S, Beltrami G, Scoccianti G, Delcroix L, Innocenti M, Capanna R. Intercalary reconstruction of femur after tumour resection: is a vascularized fibular autograft plus allograft a long-lasting solution? Bone Joint J. 2018;100-B:378–86.

    Article  CAS  Google Scholar 

  • Capanna R, Bufalini C, Campanacci M. A new technique for reconstructions of large metadiaphyseal bone defects. J Orthop Trauma. 1993;2:159–77.

    Article  Google Scholar 

  • Cheng CY, Shih HN, Hsu KY, Hsu RW. Treatment of giant cell tumor of the distal radius. Clin Orthop Relat Res. 2001:383, 221–8.

    Google Scholar 

  • Doi K, Sakai K. Vascularized periosteal bone graft from the supracondylar region of the femur. Microsurgery. 1994;15:305–15.

    Article  CAS  Google Scholar 

  • Flouzat-Lachaniette CH, Babinet A, Kahwaji A, Anract P, Biau DJ. Limited arthrodesis of the wrist for treatment of giant cell tumor of the distal radius. J Hand Surg [Am]. 2013;38:1505–12.

    Article  Google Scholar 

  • Gallardo-Calero I, Barrera-Ochoa S, Manzanares MC, Sallent A, Vicente M, Lopez-Fernandez A, De Albert M, Aguirre M, Soldado F, Velez R. Vascularized periosteal flaps accelerate osteointegration and revascularization of allografts in rats. Clin Orthop Relat Res. 2019;477:741–55.

    Article  Google Scholar 

  • Houdek MT, Wagner ER, STANS AA, Shin AY, Bishop AT, Sim FH, Moran SL. What is the outcome of allograft and intramedullary free fibula (Capanna technique) in pediatric and adolescent patients with bone tumors? Clin Orthop Relat Res. 2016;474:660–8.

    Article  Google Scholar 

  • Iorio ML, Masden DL, Higgins JP. The limits of medial femoral condyle corticoperiosteal flaps. J Hand Surg [Am]. 2011;36:1592–6.

    Article  Google Scholar 

  • Jaminet P, Rahmanian-Schwarz A, Pfau M, Nusche A, Schaller HE, Lotter O. Fibulo-scapho-lunate arthrodesis after resection of the distal radius for giant-cell tumor of the bone. Microsurgery. 2012;32:458–62.

    Article  Google Scholar 

  • Kocher MS, Gebhardt MC, Mankin HJ. Reconstruction of the distal aspect of the radius with use of an osteoarticular allograft after excision of a skeletal tumor. J Bone Joint Surg Am. 1998;80:407–19.

    Article  CAS  Google Scholar 

  • Mattos D, Ko JH, Iorio ML. Wrist arthrodesis with the medial femoral condyle flap: outcomes of vascularized bone grafting for osteomyelitis. Microsurgery. 2019;39:32–8.

    Article  Google Scholar 

  • Minami A, Kato H, Iwasaki N. Vascularized fibular graft after excision of giant-cell tumor of the distal radius: wrist arthroplasty versus partial wrist arthrodesis. Plast Reconstr Surg. 2002;110:112–7.

    Article  Google Scholar 

  • Moran SL, Shin AY, Bishop AT. The use of massive bone allograft with intramedullary free fibular flap for limb salvage in a pediatric and adolescent population. Plast Reconstr Surg. 2006;118:413–9.

    Article  CAS  Google Scholar 

  • Muramatsu K, Ihara K, Azuma E, Orui R, Goto Y, Shigetomi M, Doi K. Free vascularized fibula grafting for reconstruction of the wrist following wide tumor excision. Microsurgery. 2005;25:101–6.

    Article  Google Scholar 

  • Puloski SK, Griffin A, Ferguson PC, Bell RS, Wunder JS. Functional outcomes after treatment of aggressive tumors in the distal radius. Clin Orthop Relat Res. 2007;459:154–60.

    Article  Google Scholar 

  • Puri A, Gulia A, Agarwal MG, Reddy K. Ulnar translocation after excision of a Campanacci grade-3 giant-cell tumour of the distal radius: an effective method of reconstruction. J Bone Joint Surg (Br). 2010;92:875–9.

    Article  CAS  Google Scholar 

  • Saini R, Bali K, Bachhal V, Mootha AK, Dhillon MS, Gill SS. En bloc excision and autogenous fibular reconstruction for aggressive giant cell tumor of distal radius: a report of 12 cases and review of literature. J Orthop Surg Res. 2011;6:14.

    Article  Google Scholar 

  • Sheth DS, Healey JH, Sobel M, Lane JM, Marcove RC. Giant cell tumor of the distal radius. J Hand Surg [Am]. 1995;20:432–40.

    Article  CAS  Google Scholar 

  • Szabo RM, Anderson KA, Chen JL. Functional outcome of en bloc excision and osteoarticular allograft replacement with the Sauve-Kapandji procedure for Campanacci grade 3 giant-cell tumor of the distal radius. J Hand Surg [Am]. 2006;31:1340–8.

    Article  Google Scholar 

  • Vander Griend RA, Funderburk CH. The treatment of giant-cell tumors of the distal part of the radius. J Bone Joint Surg Am. 1993;75:899–908.

    Article  CAS  Google Scholar 

  • Weichman KE, Dec W, Morris CD, Mehrara BJ, Disa JJ. Lower extremity osseous oncologic reconstruction with composite microsurgical free fibula inside massive bony allograft. Plast Reconstr Surg. 2015;136:396–403.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Eugene Park, Steven T. Lanier & Jason H. Ko

Authors
  1. Eugene Park
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  2. Steven T. Lanier
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  3. Jason H. Ko
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Corresponding author

Correspondence to Jason H. Ko .

Section Editor information

  1. Department for Plastic, Aesthetic, Reconstructive and Hand Surgery, Evangelisches Krankenhaus, Medical Campus, University of Oldenburg, Oldenburg, Germany

    Lucian P. Jiga

Electronic Supplementary Materials

Preoperative video demonstrating that the giant cell tumor has auto-fused the patient’s wrist, but the patient has intact hand and finger function

This video demonstrates hand and finger function, including motion of his repaired extensor pollicis longus (EPL) tendon, 4 months postoperatively

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Park, E., Lanier, S.T., Ko, J.H. (2020). Augmentation of Bone Allograft with Vascularized Medial Femoral Condyle Periosteal Flap in Radius Reconstruction. In: Clinical Scenarios in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-94191-2_46-1

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  • DOI: https://doi.org/10.1007/978-3-319-94191-2_46-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-94191-2

  • Online ISBN: 978-3-319-94191-2

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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