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Background: Benign lytic lesions of bone encompass a group of neoplasm or disorders of human skeleton. Planning a treatment protocol for patients with osteolyic lesions of lower extremity involves many concerns of different risks. Especially, the reconstruction of large bony defects following surgical resection of the lesions presents a challenge for the operating surgeon. Materials and Methods: Twenty-three cases of benign bone tumors or tumor-like lesions in the lower extremities treated between April 2013 to March 2016 were retrospectively analyzed. Lesion was scooped out with extended curettage technique and the tumor wall was treated by zinc chloride. Vascularized fibular grafting with or without plate fixation were performed to reconstruct bone defect. The patients were followed up and assessed with the MSTS score (Musculoskeletal Tumor Society score) and radiological images. Results: The mean follow-up term is for 43.1 months, ranging from 24 to 77 months. One patient of giant cell tumor developed recurrence at 12-month follow-up, who finally died from lung metastasis. The other 22 patients showed no sign of recurrence. Overall, there was no evidence of avascular necrosis of fibular graft in any case. The average time of bony union between vascularized fibular graft and the receipt site was 4.3 months (rang, 2-7 months). The mean MSTS scores of pre-operation and post-operation were (80.87 ± 23. 49) % and (93.19 ± 17. 39) %, respectively, which showed that the functional outcomes of affected limbs were averagely restored to excellent level at the final follow-up. Conclusions: The outcomes showed that vascularized fibular grafting following extended curettage and zinc chloride treating is a reliable and effective surgical option in the management of benign bone tumors or tumorlike lesions in the lower extremities.

Vascularized Fibular Graft Reconstructing Large Bone Defects after Extended Curettage of Osteolytic Lesions in Lower Extremities