Composite-Free Vascularized Fibular Epiphyseal Flap and Proximal Humeral Allograft for Proximal Humerus Reconstruction in a Pediatric Patient.

Tumors involving the epiphysis in children present a reconstructive challenge. A free vascularized fibula epiphyseal transfer offers a means for biological reconstruction and longitudinal growth; however, it is often complicated by graft fracture and limited shoulder motion. Here, we present a case of a composite structural allograft with free vascularized fibula epiphyseal transfer for proximal humeral reconstruction. At 27-month follow-up, there was longitudinal growth, hypertrophy of the epiphysis, shoulder function which allowed activities of daily living, and no graft fracture.