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Combined composite osteofasciocutaneous fibular free flap and radial head arthroplasty for reconstruction of the elbow joint
Author(s) -
Alphen Nick A.,
Houdek Matthew T.,
Steinmann Scott S.,
Moran Steven L.
Publication year - 2014
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.22228
Subject(s) - medicine , radial head , surgery , elbow , prosthesis , radial head fracture , fibula , forearm , tibia
Reconstruction of the radial head can be complicated in cases of wide resection, particularly in those cases including the proximal radial shaft. In such cases, radial head replacement may not be possible because of lack of adequate bone stock. Here, we report the use of a radial head prosthesis incorporated with a vascularized fibula for immediate anatomic restoration of the forearm and elbow. We present a case of a pathologic fracture non‐union in the proximal radius in a 57‐year‐old female with a history of multiple myeloma. Non‐operative management of the fracture was unsuccessful after chemotherapy and radiation. The proximal radius and radial head were resected and reconstructed with vascularized fibula graft in conjunction with immediate radial head prosthesis. The osteotomy site healed at 6‐weeks and follow‐up at 1 year showed good functional outcome. We feel that the use of this construct has definite promise and may be considered for reconstruction following resection of the proximal radius. © 2014 Wiley Periodicals, Inc. Microsurgery 34:475–480, 2014.