Vascularized Femoral Myo‐Periosteal Graft for Congenital Pseudarthrosis of the Tibia: A Case Report

ABSTRACT Pure vascularized periosteal transplants have been shown to be extremely effective at achieving rapid bone healing in children with biologically complex non‐union. Free tibial and fibular periosteal transplants are generally indicated when large periosteal flaps are necessary. We report usi...

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Bibliographic Details
Published in:Microsurgery 2024-09, Vol.44 (6), p.e31218-n/a
Main Authors: Soldado, Francisco, Rivas‐Nicolls, Danilo, Rojas‐Neira, Juliana, Sevilla‐Tirado, Juan J., Nguyen, Trong‐Quynh, Knorr, Jorge
Format: Article
Language:English
Subjects:
Biological effects
Blood vessels
Bone grafts
Bone healing
Child
congenital pseudoarthosis
femoral periosteum
Femur
Femur - blood supply
Femur - surgery
Femur - transplantation
Grafting
Healing
Humans
Male
myo‐periosteal graf
non‐unions
Osteotomy
Osteotomy - methods
Pediatrics
Periosteum
Periosteum - transplantation
Pseudarthrosis - congenital
Pseudarthrosis - surgery
Surgery
Surgical Flaps - blood supply
Tibia
Tibia - surgery
Tibia - transplantation
Tibial Fractures - surgery
Transplants
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Summary:ABSTRACT Pure vascularized periosteal transplants have been shown to be extremely effective at achieving rapid bone healing in children with biologically complex non‐union. Free tibial and fibular periosteal transplants are generally indicated when large periosteal flaps are necessary. We report using a vascularized femoral myo‐periosteal graft (VFMPG) to treat distal tibial osteotomy non‐union in a six‐year‐old boy with congenital pseudarthrosis of the tibia. The graft consisted of a 9 cm myo‐periosteal flap (after 50% of elastic retraction) that incorporated the vastus intermedius muscle and diaphyseal femoral periosteum nourished by the descending branch of the lateral circumflex femoral vessels. Plantaris medialis was used as a recipient vessel. Healing occurred 10 weeks after surgery. The patient resumed gait and sports activity without orthosis. No donor or recipient site complications occurred 17 months after surgery. Employing a VFMPG might be an alternative to other free or large vascularized periosteal flaps currently in use for complex pediatric non‐unions.
ISSN:0738-1085
1098-2752
1098-2752
DOI:10.1002/micr.31218