Vascularized bone autografts. Experience with 41 cases.

Forty-one autogenous vascularized bone grafts have been performed by the authors since 1976. Twenty-two free vascularized fibular grafts were performed in a lower extremity and ten in an upper extremity. Ten of these patients were treated for locally aggressive, benign, or low-grade malignant bone tumors, while the remainder of the patients were treated for massive trauma-derived, segmental bone defects. The average length of the bone defect was 14.9 cm for tumor cases and 16.2 cm for trauma cases. In four patients (12.5%), the operation was unsuccessful, resulting in amputation. Nine patients were treated by osteocutaneous groin flaps, with one failure, resulting in amputation. Vascularized autogenous bone grafts transferred by microvascular anastomoses have been found an effective method of treatment for massive segmental bone defects.