Abstract
Background: Nonunion is a common complication following a fracture in the setting of previous radiotherapy; however, currently there is a paucity of data describing treatment for these nonunions in the upper extremity. Free vascularized fibular (FVF) flaps successfully treat bone defects; however, their efficacy with respect to treatment of radiated nonunions is limited. The purpose of the study was to assess the outcome following FVF for radiation-associated upper extremity nonunions. Methods: Seven patients underwent FVF for the treatment of radiation-associated upper extremity nonunion between 1998 and 2016. Results: There were 5 male and 2 female patients, with a mean age and follow-up of 44 years and 4 years, respectively. Mean total radiation dose was 41.3 Gy, given at a mean of 11 years prior to FVF. The average FVF length was 15 cm. First time union rate was 71%, however, following repeat bone grafting all patients healed. The median time to union was 10 months. Musculoskeletal Tumor Society scores improved from 57% preoperatively to 89% at latest follow-up (p < 0.0001). Conclusions: FVF is a reliable treatment option for radiation-associated nonunions of the upper extremity, providing an overall union rate of 100% and an improvement in functional outcome.
Original language | English (US) |
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Pages (from-to) | 633-637 |
Number of pages | 5 |
Journal | Journal of Plastic, Reconstructive and Aesthetic Surgery |
Volume | 73 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2020 |
Keywords
- Free vascularized fibula flap
- Nonunion
- Radiotherapy
- Upper extremity
ASJC Scopus subject areas
- Surgery