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Limb-salvage surgery is the standard care for most malignant tumors affecting the extremities, and a vascularized fibula transfer is probably the most popular microsurgical option to reconstruct long-bone defects. Skeletal reconstruction after bone-tumor resection involving the metepiphysis of a growing child can be successfully achieved with a vascularized fibula graft incorporating the proximal physis and active growth plate. Such a procedure has been utilized in 12 children under the age of 10 years who had malignant bone tumors located in the upper limb (3 in the distal radius, 9 in the proximal humerus). The follow-up ranged between 4 years and 3 months. Ten grafts were supplied by the anterior tibial artery, and two by the peroneal artery. The average growth rate of the grafts based on the former artery has been more than 1 cm per year, ranging between 0.75 and 1.33 cm. The authors describe a modified operative technique and discuss the clinical results of the procedure which offers a satisfactory skeletal reconstruction and prevents future limb-size discrepancy.

The incidence and clinical relevance of BDIs during LC in the area of Rome appeared to be stable over the past 8 years and were not influenced by the use of a prospective audit, as compared with a retrospective survey.

Patients with the Sidus Stem-Free Shoulder System achieve good clinical and radiologic short-term results that are comparable with the results of other stem-free shoulder implants.

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