Imaging of Vascularized Fibula Autograft Placed Inside a Massive Allograft in Reconstruction of Lower Limb Bone Tumors

Marco Manfrini, Daniel Vanel, Massimiliano De Paolis, Cristina Malaguti, Marco Innocenti, Massimo Ceruso, Rodolfo Capanna, Mario Mercuri

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. Bone allografts and vascularized fibula autografts were combined (the fibula inside the massive allograft) for skeletal reconstruction in a homogeneous group of patients. To verify the biologic behavior of the grafts, we followed the series using conventional radiography and CT analysis. MATERIALS AND METHODS. Twenty-four patients with bone tumors had intercalary segments of tibia or femur reconstructed and were followed up for 36-120 months. Sequential radiographs and CT scans were analyzed. RESULTS. Three types of behavior were observed. In 13 patients, the allograft maintained its architecture without fracture, although a regular enlargement of the inlaid fibula led to progressive integration with the allograft. A dense line on allograft endosteum was the first sign of bone bridges heralding fusion of the two grafts. In eight patients, fracture or nonunion of the allograft occurred, and the autograft reacted with rapid appearance of dense hypertrophy that again induced bridges to the allograft. In three patients, no changes in autograft size and density were followed by fracture with no callus formation. This behavior was interpreted as unsuccessful vascularization of the autograft. CONCLUSION. Sequential radiography and CT analysis enabled us to understand the changes in a combined graft offering an original way to revascularize bone allografts.

Original languageEnglish
Pages (from-to)963-970
Number of pages8
JournalAmerican Journal of Roentgenology
Volume182
Issue number4
Publication statusPublished - Apr 2004

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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    Manfrini, M., Vanel, D., De Paolis, M., Malaguti, C., Innocenti, M., Ceruso, M., Capanna, R., & Mercuri, M. (2004). Imaging of Vascularized Fibula Autograft Placed Inside a Massive Allograft in Reconstruction of Lower Limb Bone Tumors. American Journal of Roentgenology, 182(4), 963-970.