{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:41:19Z","timestamp":1792734079589,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Paediatric limb-salvage surgery after tumour resection is challenging because reconstruction must account for small skeletal dimensions, immature bone, and residual growth. This study aimed to evaluate the long-term clinical, radiological, functional, and oncological outcomes of vascularized fibular epiphyseal transfer (VFET) after paediatric oncological resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed nine children who underwent VFET between 1995 and 2025 at two institutions. Surgical techniques, bone union, graft hypertrophy, neo-joint remodelling, growth-related changes, complications, functional outcomes, and oncological status were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean age at surgery was 6.8\u00a0years (range, 2\u201314), and the mean follow-up was 105\u00a0months (range, 7\u2013330). Reconstruction sites included the proximal humerus, proximal radius, proximal femur, and distal tibia. Mean resection length was 12.25\u00a0cm. Bone union was achieved in seven patients after a mean of 22\u00a0months. Graft hypertrophy was observed in all patients at one year, with a mean increase of 34%. Neo-joint remodelling occurred in three patients. Two patients developed proximal humeral graft overgrowth with instability and dislocation. Mechanical complications occurred in eight patients, mainly non-union and graft fracture. One-year complication-free survival was 33\u2009\u00b1\u200916%. Functional outcomes were better in the upper limb than in the lower limb. Three-year overall survival was 71\u2009\u00b1\u200918%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VFET is a demanding biological reconstruction option in growing children after tumour resection. Although graft hypertrophy and selected joint remodelling may occur, growth behaviour is unpredictable and mechanical complications are frequent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00264-026-07005-9","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:57:03Z","timestamp":1787547423000},"page":"3007-3016","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biological reconstruction in the growing child after tumour resection: long-term outcomes of vascularized fibular epiphyseal transfer"],"prefix":"10.1007","volume":"50","author":[{"given":"Adyb - Adrian","family":"Khal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Lo Cunsolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Rampal - Rocher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean - Luc","family":"Jouve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu - Gogu","family":"Cacuci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Pesenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"7005_CR1","doi-asserted-by":"publisher","unstructured":"Picci P (2014) Epidemiology. 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