Reconstruction of post-traumatic long segment bone defects of the lower end of the femur by free vascularized fibula combined with allograft (modified Capanna’s technique)

Venkatramani, Hari; Sabapathy, S. Raja; Dheenadayalan, J; Devendra, Agraharam; Rajasekaran, S.

doi:10.1007/s00068-014-0451-2

Cited by 30 publications

(24 citation statements)

References 18 publications

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“…8 On the other hand, combined grafts (allo-bone graft shell plus vascularized allo-bone graft) can fill a bigger bone defect, but they sometimes require more time for bone union. 9 Both methods cannot avoid the problem of sacrificing normal tissue.…”

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confidence: 99%

Prefabrication of Vascularized Allogenic Bone Graft in a Rat by Implanting a Flow-Through Vascular Pedicle and Basic Fibroblast Growth Factor Containing Hydroxyapatite/Collagen Composite

Yamaguchi

Kaji

Nakamura

et al. 2017

J reconstr Microsurg

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Basic fibroblast growth factor (bFGF) is known to stimulate bone formation and angiogenesis. Hydroxyapatite/collagen composite (HAp/Col) is also known to have very strong bone conductive activity. In this study, prefabrication of vascularized allogenic bone (allo-bone) graft was attempted in recipients by implanting vascular bundles from recipients into the transplanted allo-bone graft. Furthermore, the effect of bFGF-containing HAp/Col on the prefabricated vascularized allo-bone graft was investigated. In this study, 32 Sprague-Dawley rats were used as donors, and bone grafts were collected from their femora. Thirty-two Wistar rats (recipients) were divided into four groups, and the allo-bone grafts were transplanted into the thigh region. In the experimental groups, one or both of the flow-through saphenous vascular bundles and 100-μg bFGF-containing HAp/Col were implanted into the medullary cavity of the allo-bone grafts. In the control group, neither was implanted. These rats were sacrificed at 4 weeks after transplantation, and boneformation, angiogenesis, and bone resorption in the transplanted allo-bone grafts were evaluated histologically and genetically. Bone formation and angiogenesis in the transplanted allo-bone graft were effectively stimulated by implanting vascular bundles or bFGF-containing HAp/Col on both histological and genetic evaluations compared with the control group. The most significant stimulation was observed in the group in which both were implanted. Bone resorption was not stimulated in any group. By implanting a flow-through vascular bundle and bFGF-containing HAp/Col, an ideal vascularized allo-bone graft that had high bone formative and angiogenetic activities and did not stimulate bone resorptive activity was prefabricated.

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mentioning

confidence: 99%

Prefabrication of Vascularized Allogenic Bone Graft in a Rat by Implanting a Flow-Through Vascular Pedicle and Basic Fibroblast Growth Factor Containing Hydroxyapatite/Collagen Composite

Yamaguchi

Kaji

Nakamura

et al. 2017

J reconstr Microsurg

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“…This reconstruction provides early mechanical stability, protecting the fibula from fracturing and allowing axial loading of healing bone. Free vascularized fibular graft combined with allograft Increases initial stability, allows early weight bearing, has higher chances of union and is a good single-stage technique of reconstruction of distal third femoral defects [4]. However, this technique is complex and technically demanding.…”

Section: Discussionmentioning

confidence: 99%

Successful reimplantation of extruded long bone segments in open fractures of lower limb – A report of 3 cases

Rajasekaran¹,

Devendra²,

Perumal³

et al. 2015

Injury

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“…The Capanna technique combines methods of bony reconstruction, using a VBG in conjunction with allograft bone. Variations of the technique have been described with regard to the specific placement of the VBG with respect to the allograft: it can be placed completely within the allograft's medullary canal, partially within the canal, or alongside the allograft as an onlay [13][14][15] . Here, we chose to place the VBG partially within the medullary canal, inside a trough created through the bony cortex.…”

Section: Free Fibula Graft For Oncologic Reconstructionmentioning

confidence: 99%

Reconstruction of extremity long bone defects with vascularized fibula bone grafts

Wee¹,

Ruter²,

Schulz³

et al. 2019

PAR

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Aim: Composite tissue defects encompassing bone and/or isolated bony defects can pose a surgical challenge; however, their reconstruction is critical for successful functional limb salvage. These cases become increasingly problematic as secondary defects, following multiple nonvascularized grafting attempts resulting in complex bony nonunion. Herein, our experience utilizing fibula vascularized bone grafts (VBGs) for bone restoration will be presented to demonstrate their utility in a variety of reconstructions for limb salvage. Methods: This is a case series describing a series of vascularized fibula grafts for extremity reconstruction performed by a single academic surgeon over multiple institutions in seven years. Results: Twenty-seven (27) total VBGs met inclusion criteria and underwent reconstruction for traumatic (16), oncologic (6) and chronic degenerative (5) etiologies. Bony union was achieved in 26 of 27 cases. Conclusion: The decision-making process for bony reconstruction in these scenarios is difficult and multivariable. Fibula VBGs can provide a single-stage solution for autologous bony and soft tissue replacement of large or complex bone defects and can often be superior options compared with non-vascularized bone grafts or non-bone internal fixation techniques. Their osteogenic potential is unmatched by allogenic or synthetic substitutions. These benefits are evident in a variety of clinical settings such as pediatrics, oncology and trauma.

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Reconstruction of post-traumatic long segment bone defects of the lower end of the femur by free vascularized fibula combined with allograft (modified Capanna’s technique)

Abstract: Free vascularized fibular graft combined with allograft increases initial stability, allows early weight bearing, has higher chances of union and is a good single-stage technique of reconstruction of distal third femur defects.

Cited by 30 publications

References 18 publications

Prefabrication of Vascularized Allogenic Bone Graft in a Rat by Implanting a Flow-Through Vascular Pedicle and Basic Fibroblast Growth Factor Containing Hydroxyapatite/Collagen Composite

Prefabrication of Vascularized Allogenic Bone Graft in a Rat by Implanting a Flow-Through Vascular Pedicle and Basic Fibroblast Growth Factor Containing Hydroxyapatite/Collagen Composite

Successful reimplantation of extruded long bone segments in open fractures of lower limb – A report of 3 cases

Reconstruction of extremity long bone defects with vascularized fibula bone grafts

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