Vascularized fibular epiphyseal transfer for biological reconstruction of bone defects following resection in children with proximal humeral sarcoma.

Abstract

Background: The functional reconstruction of bone defects following resection of proximal humerus tumors in children poses a significant challenge. This study utilized vascularized fibular epiphyseal transfer for proximal humerus reconstruction to evaluate the outcome, complications, and survival rates.

Methods: In this study, we conducted a retrospective analysis of 13 pediatric patients who underwent vascularized fibular epiphyseal transfer for biological reconstruction following oncologic resection of the proximal humerus between 2019 and 2021. All patients received adequate preoperative preparation and evaluation, and complications were meticulously recorded. Regular functional follow-ups and imaging evaluations were performed.

Results: A total of 13 patients with an average age of 9.8 years were included in this study. The average length of the humerus defect after surgical resection was 13.7 cm (9.4-17.8 cm). Delayed wound healing was observed in 2 patients, and one patient experienced brief common peroneal nerve palsy. There were 3 cases of graft fracture, all of which occurred within 1 year after operation. These cases were successfully managed through the application of draping plaster or brace fixation. The mean follow-up period was 39.8 months (ranging from 19 to 57 months). The mean Musculoskeletal Tumor Society (MSTS) score was 21.5 (18-24). All patients reported no persistent pain.

Conclusion: In conclusion, we assert that vascularized fibular epiphyseal transfer provides a reliable and promising option for reconstruction in pediatric patients undergoing proximal humerus tumor resection surgery. Graft fractures were the most prevalent complication, emphasizing the importance of cautionary measures to prevent falls or trauma. However, further validation through increased case numbers and extended follow-up periods is necessary.