From Survival to Living: A Comprehensive Analysis of Fibula Graft Complications, Functional Outcomes, and Quality of Life Following Reconstruction for Malignant Bone Tumors
Year: 2026
Type: dissertation
Study design: Observational Study
Abstract: BACKGROUND: Although survival rates for patients with malignant bone tumors have improved significantly, complications following tumor resection and limb-sparing reconstruction remain a major clinical challenge, particularly in young individuals. Intercalary resection often results in large bone defects, necessitating complex reconstructions. Fibula grafts offer biological advantages; however, their long-term outcomes, especially regarding mechanical complications and comprehensive patient-reported well-being, require further detailed exploration, particularly in cohorts utilizing non-vascularized grafts. OBJECTIVE: This retrospective study evaluated the complication rates, bone hypertrophy, limb function, and quality of life following non-vascularized fibular graft reconstruction for malignant bone tumors in a single-center cohort. This study offers insights into long-term success and patient well-being, with a particular focus on correlations with systemic therapy and defect size, factors that remain insufficiently explored in the current literature. METHODS: In this single-center retrospective study, twenty-four non-vascularized fibular grafts were used to reconstruct intercalary bone defects following malignant tumor resection. Complications were categorized using the Clavien-Dindo classification. Graft hypertrophy was evaluated according to the method described by Weiland and de Boer. Functional outcomes were assessed using the MSTSs and TESSs, while quality of life was measured using the SF-36 questionnaire. Notably, the cohort analyzed represents a relatively large single-center series focusing exclusively on the outcomes of non-vascularized fibular grafts. RESULTS: = 0.013), identifying critical risk factors. Despite these considerable complication rates, patients achieved satisfactory limb function (MSTS: 74 ± 17; TESS: 83 ± 15) and quality of life scores comparable to national norms, with notably higher mental health indices, highlighting their psychological resilience. CONCLUSIONS: Non-vascularized fibular graft reconstruction, despite high mechanical complication rates, significantly facilitates long-term functional recovery and psychological well-being. These findings emphasize the necessity of risk-adapted surgical strategies and long-term follow-up protocols to mitigate complications, optimize long-term function, and ultimately advance patient-centered care.
Source: Cancers
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W7160843819