Reconstruction of Massive Femur Defect with Free Vascularized Fibula Graft Following Tumor Resection

Background: The reconstruction of femur defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (FVFG) reconstruction for massive femur defects of more than 10 cm that were secondary to skeletal tumor resection is reported. Patients and Methods: Six patients with a mean of 3.3 years follow-up were reviewed. Five patients received double or folded vascularized fibula grafts and 1 received a single graft. The mean bony defect of the femur was 13 cm and the mean length of grafted fibula was 15 cm. Results: Five patients were free of disease at final follow-up; 10 out of 11 (91%) FVFGSs were transferred successfully. Five patients had a successful outcome with bony union. No stress fractures had occurred up until the final follow-up. All patients except one could walk without a brace after a mean of 9 months post-operatively. Conclusion: Double or folded FVFG is a reliable reconstructive procedure for massive femur defects.