Vascularised bone transfer: History, blood supply and contemporary problems

Repair of Large Segmental Bone Defect using Vascularized Small Corticocancellous Bone in Rabbit Femur

“…It can be harvested from any site with a nutrient vessel to the bone and can be easily transferred without vascular anastomosis (►Table 4). [12][13][14][15] Since the description of the free fibula flap by Taylor in 1975, a large number of vascularized bone have been described. 10, Available vascularized bones exist in the almost all human bone and can be transferred at least as a small pedicled vascularized bone for reconstruction of adjacent bone defect.…”

Bone reconstruction: A history of vascularized bone transfer

“…Following this report, the free fibula flap emerged as a workhorse option for free tissue transfer in the setting of major bone defects (Taylor et al, ), especially of the long bone and mandible. Other anatomical locations exploited for the purpose of free bone transfer expanded and included the iliac crest, scapula, radius, and more recently the medial femoral condyle (Sparks et al, ). Many of these flaps continue to be used today for a range of defects, particularly the craniofacial skeleton after tumor ablation and the long bones following trauma, infection, and malignancy (Taylor et al, ).…”

“…Free vascularized bone transfer has evolved to become an accepted and often the preferred reconstruction for critical size bone defects in both the axial and appendicular skeleton (Sparks et al, ). A review of its history shows a stepwise evolution in the complexity of vascularized bone grafts, that, following the recognition of blood supply preservation in healing, has matched the reconstructive indications at respective time points in history.…”

“…Experimentation with non‐vascularized bone graft, both autologous and allogeneic, followed throughout the 19th century until it was fully appreciated that preservation of a blood supply to bone prevented resorption and improved the likelihood of bone healing (Curtis, ). And so the scene was set, as surgeons, biologists, and immunologists recognized that in order to preserve the structural integrity of bone, it should retain a blood supply and be harvested from an autologous source (Sparks et al, ).…”

“…Following this report, the free fibula flap emerged as a workhorse option for free tissue transfer in the setting of major bone defects(Taylor et al, 2016), especially of the long bone and mandible. Other anatomical locations exploited for the purpose of free bone transfer expanded and included the iliac crest, scapula, radius, and more recently the medial femoral condyle(Sparks et al, 2017). Many of these flaps continue to be used today for a range of defects, particularly the craniofacial skeleton after tumor ablation and the long bones following trauma, infection, and malignancy(Taylor et al, 2016).7 | EM E R GI NG ROL E S FOR V A SCU L AR I SED BON E TRA N S F ER Novel modes of bone reconstruction are emerging and the role of vascularized bone transfer appears to have evolved alongside these FIG URE 4 This series of X-rays show the progressive healing of the first successful clinical free vascularized bone flap transfer to reconstruct a traumatic 12.5-cm defect of the tibia.…”