The Experts below are selected from a list of 1068 Experts worldwide ranked by ideXlab platform
Akira Kawai - One of the best experts on this subject based on the ideXlab platform.
-
Clinical Study Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized AutoGraft and a Vascularized Fibula
2020Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization ( = 6), deep freezing ( = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur ( = 10), tibia ( = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications.
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications. We conducted a retrospective review of 9 consecutive patients (5 male, 4 female; mean age 31 years) who underwent pelvic ring reconstruction using a double-barreled free VFG after internal hemipelvectomy (P1, n = 4; P1 + 4, n = 3; P1 + 2, n = 2) at our institution between 1998 and 2013. The mean follow-up period was 55 months (range 3–131 months). The mean length of the bone defect was 9 cm. The methods of fixation included a Cotrel-Dubosset rod (n = 4), screw (n = 3), and screw and plate (n = 2). Bone union was achieved in 5 of 8 patients (63 %) over a 1-year follow-up. The mean period required for bone union was 5.4 months (range 3–7 months). There were 3 early postoperative complications: 2 deep infections resulting in Graft removal and 1 implant failure resulting in non-union. Among 3 patients, 2 developed scoliosis within 5 years. One patient developed lumbar disc hernia as a result of scoliosis, for which surgical intervention was required. The mean Musculoskeletal Tumor Society score was 57 % at the last follow-up. In conclusion, this reconstruction method can achieve an early and high rate of bone union and provide good functional outcome. However, follow-up with careful attention to postoperative complications, including deep infection in the early postoperative period and spinal deformity in the long term, is necessary.
-
intercalary reconstruction after wide resection of malignant bone tumors of the lower extremity using a composite Graft with a devitalized autoGraft and a vascularized Fibula
Sarcoma, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization (n = 6), deep freezing (n = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur (n = 10), tibia (n = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts.
Koichi Ogura - One of the best experts on this subject based on the ideXlab platform.
-
Clinical Study Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized AutoGraft and a Vascularized Fibula
2020Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization ( = 6), deep freezing ( = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur ( = 10), tibia ( = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications.
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications. We conducted a retrospective review of 9 consecutive patients (5 male, 4 female; mean age 31 years) who underwent pelvic ring reconstruction using a double-barreled free VFG after internal hemipelvectomy (P1, n = 4; P1 + 4, n = 3; P1 + 2, n = 2) at our institution between 1998 and 2013. The mean follow-up period was 55 months (range 3–131 months). The mean length of the bone defect was 9 cm. The methods of fixation included a Cotrel-Dubosset rod (n = 4), screw (n = 3), and screw and plate (n = 2). Bone union was achieved in 5 of 8 patients (63 %) over a 1-year follow-up. The mean period required for bone union was 5.4 months (range 3–7 months). There were 3 early postoperative complications: 2 deep infections resulting in Graft removal and 1 implant failure resulting in non-union. Among 3 patients, 2 developed scoliosis within 5 years. One patient developed lumbar disc hernia as a result of scoliosis, for which surgical intervention was required. The mean Musculoskeletal Tumor Society score was 57 % at the last follow-up. In conclusion, this reconstruction method can achieve an early and high rate of bone union and provide good functional outcome. However, follow-up with careful attention to postoperative complications, including deep infection in the early postoperative period and spinal deformity in the long term, is necessary.
-
intercalary reconstruction after wide resection of malignant bone tumors of the lower extremity using a composite Graft with a devitalized autoGraft and a vascularized Fibula
Sarcoma, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization (n = 6), deep freezing (n = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur (n = 10), tibia (n = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts.
Hirokazu Chuman - One of the best experts on this subject based on the ideXlab platform.
-
Clinical Study Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized AutoGraft and a Vascularized Fibula
2020Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization ( = 6), deep freezing ( = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur ( = 10), tibia ( = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications.
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications. We conducted a retrospective review of 9 consecutive patients (5 male, 4 female; mean age 31 years) who underwent pelvic ring reconstruction using a double-barreled free VFG after internal hemipelvectomy (P1, n = 4; P1 + 4, n = 3; P1 + 2, n = 2) at our institution between 1998 and 2013. The mean follow-up period was 55 months (range 3–131 months). The mean length of the bone defect was 9 cm. The methods of fixation included a Cotrel-Dubosset rod (n = 4), screw (n = 3), and screw and plate (n = 2). Bone union was achieved in 5 of 8 patients (63 %) over a 1-year follow-up. The mean period required for bone union was 5.4 months (range 3–7 months). There were 3 early postoperative complications: 2 deep infections resulting in Graft removal and 1 implant failure resulting in non-union. Among 3 patients, 2 developed scoliosis within 5 years. One patient developed lumbar disc hernia as a result of scoliosis, for which surgical intervention was required. The mean Musculoskeletal Tumor Society score was 57 % at the last follow-up. In conclusion, this reconstruction method can achieve an early and high rate of bone union and provide good functional outcome. However, follow-up with careful attention to postoperative complications, including deep infection in the early postoperative period and spinal deformity in the long term, is necessary.
-
intercalary reconstruction after wide resection of malignant bone tumors of the lower extremity using a composite Graft with a devitalized autoGraft and a vascularized Fibula
Sarcoma, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization (n = 6), deep freezing (n = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur (n = 10), tibia (n = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts.
Shimpei Miyamoto - One of the best experts on this subject based on the ideXlab platform.
-
Clinical Study Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized AutoGraft and a Vascularized Fibula
2020Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization ( = 6), deep freezing ( = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur ( = 10), tibia ( = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications.
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications. We conducted a retrospective review of 9 consecutive patients (5 male, 4 female; mean age 31 years) who underwent pelvic ring reconstruction using a double-barreled free VFG after internal hemipelvectomy (P1, n = 4; P1 + 4, n = 3; P1 + 2, n = 2) at our institution between 1998 and 2013. The mean follow-up period was 55 months (range 3–131 months). The mean length of the bone defect was 9 cm. The methods of fixation included a Cotrel-Dubosset rod (n = 4), screw (n = 3), and screw and plate (n = 2). Bone union was achieved in 5 of 8 patients (63 %) over a 1-year follow-up. The mean period required for bone union was 5.4 months (range 3–7 months). There were 3 early postoperative complications: 2 deep infections resulting in Graft removal and 1 implant failure resulting in non-union. Among 3 patients, 2 developed scoliosis within 5 years. One patient developed lumbar disc hernia as a result of scoliosis, for which surgical intervention was required. The mean Musculoskeletal Tumor Society score was 57 % at the last follow-up. In conclusion, this reconstruction method can achieve an early and high rate of bone union and provide good functional outcome. However, follow-up with careful attention to postoperative complications, including deep infection in the early postoperative period and spinal deformity in the long term, is necessary.
-
intercalary reconstruction after wide resection of malignant bone tumors of the lower extremity using a composite Graft with a devitalized autoGraft and a vascularized Fibula
Sarcoma, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization (n = 6), deep freezing (n = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur (n = 10), tibia (n = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts.
Tomohiro Fujiwara - One of the best experts on this subject based on the ideXlab platform.
-
Clinical Study Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized AutoGraft and a Vascularized Fibula
2020Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization ( = 6), deep freezing ( = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur ( = 10), tibia ( = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications.
-
pelvic ring reconstruction with a double barreled free vascularized Fibula Graft after resection of malignant pelvic bone tumor
Archives of Orthopaedic and Trauma Surgery, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:In patients undergoing limb-salvage internal hemipelvectomy, pelvic ring reconstruction is mandatory to maintain the stability of the pelvis and the spinal column, which finally expected to achieve a good functional outcome. However, no optimal reconstruction method has been established. In addition, no previous reports have highlighted the long-term complications of pelvic ring reconstruction after internal hemipelvectomy. We aimed to analyze the outcome of pelvic ring reconstruction using a double-barreled free vascularized Fibula Graft (VFG) after internal hemipelvectomy with special reference to long-term complications. We conducted a retrospective review of 9 consecutive patients (5 male, 4 female; mean age 31 years) who underwent pelvic ring reconstruction using a double-barreled free VFG after internal hemipelvectomy (P1, n = 4; P1 + 4, n = 3; P1 + 2, n = 2) at our institution between 1998 and 2013. The mean follow-up period was 55 months (range 3–131 months). The mean length of the bone defect was 9 cm. The methods of fixation included a Cotrel-Dubosset rod (n = 4), screw (n = 3), and screw and plate (n = 2). Bone union was achieved in 5 of 8 patients (63 %) over a 1-year follow-up. The mean period required for bone union was 5.4 months (range 3–7 months). There were 3 early postoperative complications: 2 deep infections resulting in Graft removal and 1 implant failure resulting in non-union. Among 3 patients, 2 developed scoliosis within 5 years. One patient developed lumbar disc hernia as a result of scoliosis, for which surgical intervention was required. The mean Musculoskeletal Tumor Society score was 57 % at the last follow-up. In conclusion, this reconstruction method can achieve an early and high rate of bone union and provide good functional outcome. However, follow-up with careful attention to postoperative complications, including deep infection in the early postoperative period and spinal deformity in the long term, is necessary.
-
intercalary reconstruction after wide resection of malignant bone tumors of the lower extremity using a composite Graft with a devitalized autoGraft and a vascularized Fibula
Sarcoma, 2015Co-Authors: Koichi Ogura, Minoru Sakuraba, Shimpei Miyamoto, Tomohiro Fujiwara, Hirokazu Chuman, Akira KawaiAbstract:Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autoGraft and a vascularized Fibula Graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years) undergoing reconstruction using a devitalized autoGraft (pasteurization (n = 6), deep freezing (n = 5)) and a vascularized Fibula Graft composite for lower extremity malignant bone tumors (femur (n = 10), tibia (n = 1)). Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autoGraft, 1 frozen autoGraft) and 1 fracture and 1 implant failure (both in pasteurized autoGrafts). Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autoGraft, our novel method involving a combination of a frozen autoGraft with a vascularized Fibula Graft and rigid fixation with a locking plate may offer better outcomes than previously reported alloGrafts or devitalized autoGrafts.