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Ozols D, Protasa J, Bergmanis U, Berezovska MM, Kalnina L, Ozola S, Petersons A. Double vascularized fibula growth plate transfer for the reconstruction of long segmental tibia in pediatric patients: Report of three cases. Microsurgery 2023; 43:68-73. [PMID: 35134269 DOI: 10.1002/micr.30872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/24/2021] [Accepted: 01/28/2022] [Indexed: 01/12/2023]
Abstract
Osteosarcoma is a common bone tumor for pediatric patients that has a complex treatment including chemotherapy and radical surgical resection. There are few functional leg reconstruction possibilities described in the literature for pediatric patients due to limited growth potential. The aim of this report is to show long-term results using double vascularized growth plate flaps for the long segmental tibial reconstruction in growing children with satisfactory functionality and preserved limb growth without the use of permanent foreign materials. Three patients with sarcoma in the proximal part of the tibial bone were treated with complex therapy that included preoperative chemotherapy, radical resection of proximal metaepiphysis with tibial growth plate and half of the diaphysis and transplantation of double fibula growth plate flaps-the pedicled ipsilateral and the contralateral as a microvascular flap. The first patient, a male, 13 year with periosteal sarcoma, underwent 17 cm tibial resection with transplantation of the ipsilateral fibula 20 cm and contralateral fibula 20.1 cm, and continued follow-up for 6 years. The second patient, a male, 6 years of age with osteosarcoma, had 14 cm tibial resection with 16 cm ipsilateral and 16.1 cm contralateral fibular transplantation, continued follow-up for 5 years. The third patient, a female, 12 years of age with osteosarcoma, underwent 14 cm tibial resection with 15.4 cm ipsilateral and 15.9 cm contralateral fibular transplantation, and current follow-up of 1 year. Double fibular growth plate transfer is limb-sparing method for a proximal tibial reconstruction with natural growth potential for the pediatric patients.
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Affiliation(s)
- Dzintars Ozols
- Riga Stradins University, Riga, Latvia.,Department of Hand and Plastic Surgery, Microsurgery Centre of Latvia, Riga East University Hospital, Riga, Latvia.,Department of pediatric surgery, Children's Clinical University Hospital, Riga, Latvia
| | - Jana Protasa
- Riga Stradins University, Riga, Latvia.,Department of pediatric surgery, Children's Clinical University Hospital, Riga, Latvia
| | - Uldis Bergmanis
- Department of pediatric surgery, Children's Clinical University Hospital, Riga, Latvia
| | - Marisa Maija Berezovska
- Riga Stradins University, Riga, Latvia.,Department of pediatric surgery, Children's Clinical University Hospital, Riga, Latvia
| | | | | | - Aigars Petersons
- Riga Stradins University, Riga, Latvia.,Department of pediatric surgery, Children's Clinical University Hospital, Riga, Latvia
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