Vascularized free fibula transfer remains the gold standard for reconstruction of large segmental diaphyseal defects of the upper extremity. In the pediatric patient, before skeletal maturity, free fibula transfer with the fibular head provides an active physis for growth and an articular interface for glenohumeral joint reconstruction. Clinical and cadaveric studies have demonstrated that the vascular supply to the fibular head originates, in most cases, from the anterior tibial system. However, anatomical variation exists, and we report a case in which a vascularized fibula autograft including the physis was transferred on the peroneal artery in a 5-year-old patient with Ewing’s sarcoma. At 15-month follow-up, the patient has functional range of motion of the shoulder.
From the *Division of Plastic and Reconstructive Surgery, Children’s National Medical Center, Washington, D.C.; and †Department of Orthopedic Surgery, Medstar Cancer Institute, Washington, D.C.
Received for publication March 27, 2016; accepted October 5, 2016.
Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.
Benjamin C. Wood, MD, Plastic and Reconstructive Surgery, Children’s National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010, E-mail: email@example.com
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