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Vascularised rib graft defects of the diaphysis of the humerus in children

A REPORT OF TWO CASES

Department of Orthopaedic Surgery

N. Shetty, MCh, Professor and Head

Department of Cardiothoracic and Vascular Surgery, M S Ramaiah Medical Teaching Hospital and Medical College, PO Box 5425, MSRIT Post, Bangalore 560 054, India.

Correspondence should be sent to Professor D. C. Sundaresh at Olaya Medical Centre, PO Box 577 96, Riyadh 11584, Kingdom of Saudi Arabia.

In our practice sequestration of the shafts of long bones in children because of acute osteomyelitis continues to be a problem. Conventional procedures for bone grafting are likely to fail. Vascularised grafts with microvascular anastomosis are technically demanding with a high rate of failure. Transfer of the rib on its vascular pedicle to achieve anterior fusion in the thoracic spine is now well established and the length of the pedicle available is adequate to allow grafting of a diaphyseal defect in the humerus. We describe the successful use of this procedure in two patients.