{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T21:12:35Z","timestamp":1780693955246,"version":"3.54.1"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J reconstr Microsurg"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>\n            Background\u2003Most reports on skeletal reconstruction using vascularized fibular free flap include patients with varying age groups and anatomic locations. This study has limited the inclusion criteria to pediatric and adolescent patients diagnosed with bone sarcoma of the femoral shaft.<\/jats:p><jats:p>\n            Methods\u2003Forty-one patients, diagnosed with a malignant bone tumor of the femoral shaft (21 Ewing's sarcomas and 20 osteosarcomas), were locally treated by joint sparing wide resection and reconstruction using a vascularized fibular free flap. All clinical and radiographic data were reviewed for graft healing and hypertrophy as well as oncologic and functional outcome.<\/jats:p><jats:p>\n            Results\u2003The mean follow-up period was 48.7 months (12\u2013104 months). The mean age at presentation was 10.3 years (5\u201317 years). The average length of the resected femoral shaft was 19.2 cm (15\u201324 cm) and the average length of the harvested fibula was 17.4 cm (15\u201321 cm). The mean time to union was 4.8 months (1\u20136 months) and the mean hypertrophy index was 78% (15.5\u2013184%). Complications included 12 fractures (33.3%), 5 non-unions (13.8%), and 5 failures of graft hypertrophy (13.8%). At the latest clinical evaluation, the mean MSTS score was 81% (56\u2013100%) and the mean limb length inequality was 4.75 cm (3\u201311 cm).<\/jats:p><jats:p>\n            Conclusion\u2003Despite the high functional demand and deleterious effect of chemotherapy on bone healing, reconstruction of the femur by vascularized fibular free flap in pediatric bone sarcomas can lead to a good functional outcome. Complications, such as fracture and non-union, can be successfully treated by revision of fixation and autologous iliac crest grafting.<\/jats:p><jats:p>\n            Level of Evidence\u2003IV.<\/jats:p>","DOI":"10.1055\/s-0038-1668142","type":"journal-article","created":{"date-parts":[[2018,8,18]],"date-time":"2018-08-18T22:30:50Z","timestamp":1534631450000},"page":"156-162","source":"Crossref","is-referenced-by-count":16,"title":["Use of Vascularized Fibular Free Flap in the Reconstruction of the Femur in Pediatric and Adolescent Bone Sarcomas: Complications and Functional Outcome"],"prefix":"10.1055","volume":"35","author":[{"given":"Magdy","family":"Sherbiny","sequence":"first","affiliation":[{"name":"Department of Orthopedic, Children's Cancer Hospital, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehal","family":"Kamal","sequence":"first","affiliation":[{"name":"Department of Orthopedic, Children's Cancer Hospital, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Ghoneimy","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Children's Cancer Hospital, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,8,18]]},"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1668142.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T23:39:08Z","timestamp":1548891548000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1668142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,18]]},"references-count":0,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2019,1,30]]},"published-print":{"date-parts":[[2019,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1668142","relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,18]]}}}