Free vascularized fibula and reconstruction of long bones in the child--our evolution.

The aim is to show our evolution for reconstruction of long bones in the child with free vascularized fibula after tumoral resection. Between 1990 and 2004, 78 children were operated on for sarcoma of long bones and one girl with congenital pseudarthrosis. The main applications are illustrated: U-shaped fibular transplant, fibular epiphysis with growth plate and diaphysis transfer, fibular graft associated to massive allograft. Follow-up of the children was performed by clinical examination and standard X-ray. No post operative death occurred. Many benign complications for femoral reconstruction were observed. So our recent evolution is to use vascularized fibula associated with massive allograft; but resorption of allograft was observed 3 years later. Vascularized fibula for reconstruction of long bones is the ideal material. The result is definitive. The future for femur is perhaps vascularized fibula associated with osseous substitute.