Seven major reconstructions of the femoral shaft using a vascularized
graft of bone from the fibula were performed at the Massachusetts General
Hospital from 1981 to 1984. Three patients had a post-traumatic infected
non-union; one, extensive osteomyelitis of the femoral shaft; one, a
fractured allograft; one, an atrophic non-union associated with radiation
therapy; and one, post-traumatic loss of a ten-centimeter segment of bone.
Six of the seven patients had a skeletal femoral defect, ranging from seven
to fifteen centimeters in length. The average length of fibula that was
used for reconstruction was 19.6 centimeters. Primary skeletal union
occurred in five of the seven patients. Two patients had healing only at
the distal junction and required a conventional bone graft and
supplementary internal fixation of the proximal junction. At an average
length of follow-up of thirty-four months, all of the patients were able to
walk. Only two patients, both of whom had an extreme limb-length
discrepancy, required additional support.