{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:27:49Z","timestamp":1787754469486,"version":"build-2784847793"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>For intercalary defects after resection of pediatric sarcoma, an isolated vascularized free fibular graft (VFFG) offers a living bone option with the potential for durability but is underutilized due to concerns about mechanical sufficiency. By contrast, structural allograft is initially strong but is associated with a high complication profile with or without a composite VFFG (Capanna). Our aim was to compare the complications associated with allograft\/VFFG composites to isolated VFFG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a retrospective comparison of 32 pediatric patients with primary femoral or tibial sarcoma. Reconstructions were categorized into 2 groups: allografts + VFFG (Capanna) (Group 1, n = 9) and \u201csingle barrel\u201d isolated VFFG (Group 2, n = 23). Descriptive and inferential statistical analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>No significant differences between the 2 groups were observed in age, sex, diagnosis, length of reconstruction, or follow-up (56 months (SD 29) for Group 1 and 53 months (SD 24) for Group 2). Group 1 participants exhibited a higher number of complications including the need for unplanned surgery (mean 2.9) compared with those in Group 2 (mean 1.6, p &amp;lt; 0.01). Disparities in bone healing were notable. At the final follow-up, 46% in Group 1 had achieved full consolidation compared with 96% in Group 2 (p = 0.002). Graft fractures and hardware failures were not different between the groups despite full weight-bearing among all subjects, suggesting mechanical equivalency within the follow-up period. The mean numbers of unplanned surgeries per participant were 4.2 \u00b1 SD 4.4 and 2.3 \u00b1 SD 2.5 for Groups 1 and 2, respectively (p = 0.149).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Isolated single barrel VFFG reconstructions are structurally sound and had fewer complications and faster union than composite allograft\/VFFG composites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Retrospective cohort study\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.25.00267","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T19:00:28Z","timestamp":1768590028000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Sufficiency of Isolated Vascularised Fibular Free Flaps for Pediatric Intercalary Lower Limb Reconstruction"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2098-3601","authenticated-orcid":false,"given":"Laura","family":"Saenz","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Canada"},{"name":"Current Address: Orthopedics and Traumatology, Clinica Pedi\u00e1trica Kidoz, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen W.","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada"},{"name":"Division of Plastic, Reconstructive, & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2974-9413","authenticated-orcid":false,"given":"Kristen M.","family":"Davidge","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada"},{"name":"Division of Plastic, Reconstructive, & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, 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