USING VASCULARIZED FIBULA GRAFT IN TREATMENT CHILDREN WITH BONE DEFECTS - THE POSSIBILITY OF FURTHER RECONSTRUCTIVE SURGERY
eliminating a defect of the femur, consisting in replacing the defect of the left femur by autotransplantation of a fragment of the fibula using microsurgical techniques and two stages of lengthening the limb using distraction osteosynthesis is presented. The patient admitted to the clinic of the institute at the age of 7 years, after a previous acute hematogenous osteomyelitis of the left femur, exacerbation of the process after 5 months from the start of therapy and the formation of a defect with a length of 10 cm (after sequestratomy). The first stage was microsurgical transplantation of a blood-supplied fragment of the fibula to the position of the defect; consolidation was achieved at the graft-bone border. The second and third stages were the lengthening of the affected segment of the lower limb by the method of distraction osteosynthesis. In total, the femur is lengthened by 20 centimeters. There were no vascular and neurological disorders during the observation period of the patient. The presented case demonstrates the option of eliminating the defect and restoring the length of the affected segment of the lower limb after suffering hematogenous osteomyelitis. The use of microsurgical transplantation of a blood-supplied fragment of the fibula into the position of the femur defect ensured the support ability of the affected lower limb, and the transformation of the fibula as a result of axial loading made it possible to shorten the rehabilitation and socialization of the patient by lengthening the limb using distraction osteosynthesis due to the affected segment.