Novel Dual Bicolumnar Fibula Graft Reconstruction of Distal Humerus in Pediatric Patients After Massive Bone Resection: A Report of Two Cases

JBJS Case Connect. 2024 Jun 24;14(2). doi: 10.2106/JBJS.CC.23.00539. eCollection 2024 Apr 1.

Abstract

Case: We describe 2 case studies, involving a 10-year-old girl with an aneurysmal bone cyst and a 12-year-old adolescent boy with Ewing sarcoma. The patient with Ewing sarcoma was previously managed with wide surgical excision and fibular graft reconstruction and subsequently experienced significant graft resorption, hardware failure, and fracture 24 months after operation. A revision limb salvage attempt was undertaken. In both cases, fibular strut grafts were harvested and fixed with intramedullary k-wires to recreate the medial and lateral columns of the distal humeral triangle.

Conclusion: The technique achieved complete osseous integration, structural support, and functional restoration of the elbow in both cases, with good functional outcomes.

Publication types

  • Case Reports

MeSH terms

  • Bone Cysts, Aneurysmal / diagnostic imaging
  • Bone Cysts, Aneurysmal / surgery
  • Bone Neoplasms* / surgery
  • Bone Transplantation / methods
  • Child
  • Female
  • Fibula* / surgery
  • Fibula* / transplantation
  • Humans
  • Humerus* / surgery
  • Male
  • Plastic Surgery Procedures / methods
  • Sarcoma, Ewing* / surgery