Evaluation of the results of reconstruction of large bony defects of humerus using vascularized bone grafts

Background: Vascularized bone grafts (VBGs) are currently the main surgical option for the restoration of humeral bone defects particularly when defects are larger than 6 cm. Because it offers a strong, rapid blood supply, VBGs easily integrate into the recipient sites and undergo active resorption and remodeling into healthy bone through primary bone healing. Additionally, they support the recipient site's immune system in preventing and reducing infection.The Aim was to assess the outcomes of utilizing vascularized bone grafts to reconstruct large humeral bony defects (greater than 6 cm).

Patients and methods: This study comprised twenty patients with major humeral bony defects treated by vascularized bone grafts. Under general anesthesia, the procedure was carried out with the patient in the supine position for free fibula harvesting or in the lateral or prone position for pedicled scapular graft harvesting.

Results: The union rate was 90 % and the mean healing time was 7.78 ± 3.04 months. Complications were present in 40 % of cases, with non-union being the most common, followed by infection and wound dehiscence.

Conclusion: The study suggests that the reconstruction of large bony defects of humerus using vascularized bone grafts is effective, with a predictable healing time and a manageable complication rate.