Comparison of Pediatric Intercalary Allograft Reconstructions With and Without a Free Vascularized Fibula

Introduction: Lower extremity intercalary allograft reconstruction has traditionally been used to facilitate limb salvage. Combing the allograft with a vascularized fibula graft (FVFG) has been described; however there is a paucity of data comparing the outcome of these reconstructions. Material and Methods: 29 pediatric patients (15 males, 14 females) underwent lower extremity limb salvage with the use of intercalary cadaveric allograft at a mean age of 12 years. The most common diagnosis was osteosarcoma (n=18). Patients were reconstructed with an allograft alone (n=11) or supplemented with a FVFG (n=18). Results: The mean time to union of the allograft was 11 months, with 10 patients requiring additional bone grafting. There was no difference in the need for an additional bone graft (OR 0.87, P=1.0) between patients with a FVFG and those without. The allograft was revised in 3 patients due to fracture (n=2) and fracture and infection (n=1). In all these patients the allograft was not supplemented with a FVFG (P