{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:08Z","timestamp":1786978268625,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Reconstructing large bone defects for lower limb salvage in the pediatric population remains challenging due to complex oncological or septic issues, limited surgical options, and lengthy procedures prone to complications. The vascularized double\u2010barreled fibula free flap is pivotal for reconstructing large bones. In this article, we report our experience with this technique in the surgical management of pediatric tibial bone defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of patients under 18\u2009years of age who underwent tibial reconstruction using a double\u2010barreled fibula free flap at our center between 2004 and 2023. Collected data included demographic information, operative details, time to bone consolidation and full weight\u2010bearing, and functional outcomes using the Musculoskeletal Tumor Society (MSTS) score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight patients (5 females, 3 males) with a mean age of 12.5\u2009years (range 5\u201317) were included. The average tibial defect length was 11.2\u2009cm (range 7\u201314\u2009cm), affecting the proximal tibia in 4 cases (50%), the middle third in 3 cases (37.5%), and the distal third in 1 case (12.5%). Reconstruction followed oncologic resection in 7 patients (87.5%) and addressed congenital pseudarthrosis in 1 patient (12.5%).<\/jats:p>\n                    <jats:p>One patient died of sarcoma. Six patients (75%) achieved full weight\u2010bearing within a median of 7\u2009months (range 6\u201316) and a bone consolidation at 9\u2009months in median (range 6\u201318). One reconstruction (12.5%) failed due to septic pseudarthrosis leading to a below\u2010knee amputation. The mean MSTS score was 81.65 (range 63.3\u2013100).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study is the first to focus on pediatric tibial reconstructions using the double\u2010barreled vascularized fibula free flap. It highlights the technique's reliability for reconstructing tibial defects, particularly in intermediate\u2010sized cases (7\u201314\u2009cm). This single\u2010stage procedure minimizes stress fracture risk, enables earlier weight\u2010bearing, and is an alternative to the Capanna technique without requiring an allograft.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70024","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T22:44:59Z","timestamp":1738017899000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Double\u2010Barreled Vascularized Fibula Free Flap in Pediatric Tibial Bone Defect Reconstruction: A 20\u2010Year Monocentric Experience"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1857-9263","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Thuau","sequence":"first","affiliation":[{"name":"Plastic, Reconstructive, and Aesthetic Surgery Unit Nantes University Hospital  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Hamel","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Nantes University Hospital  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck","family":"Duteille","sequence":"additional","affiliation":[{"name":"Plastic, Reconstructive, and Aesthetic Surgery Unit Nantes University Hospital  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010200206000\u201000021"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278\u20102391(98)90914\u20104"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30487"},{"issue":"1","key":"e_1_2_11_5_1","first-page":"73","article-title":"Microvascular Free Bone Transfer With Revascularization of the Medullary and Periosteal Circulation or the Periosteal Circulation Alone. 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