Organ-saving operation with th use of vascu- larised autografts in patients with malignant tumors of extermities

Organ-saving operations with the use of vascularised autografts were carried out in 134 patients with malignant tumors of extremity. Depending on the type of tumors processes the surgical method was applied either as an independent one or in combination with radio- and chemotherapy. In 8 patients the restoration of soft tissue defects was required, in 9 patients the restoration of bone defects was required, and in 17 patients had vast bone- soft tissue defects as well as defects involving large joints. In patients with the defetcs which required only restoration of soft tissue scapular (1), thoracodorsal (5) flaps and simultaneously two flaps on the common or separate vascular pedicles were applied (2). The length of bone defects ranged from 12 cm to 30 cm, in overwhemling majority of cases (22) it exceeded 20 cm. Due to real danger of graft fracture under load in vast bone defects of low extremities the double graft from fibula (2) or two bone grafts from both fibulae were used when possible (5). Osteosynthesis was carried out by plates, and by different extrafocal fixation devices. The grafts’ healing was 100%. In one case there was a complication in the donor zone manifested by necrosis of the remained part of fibulae muscles after fibula was taken. It was considered to be a result of technical mistake. The method allowed to improve significantly the functional results of treatment in patients with malignant tumors of the extremities.