Does Distal Radius Reconstruction by Free Epiphyseal Transfer Lead to Inferior Radioulnar Dissociation?

Purpose: The aim of this study is to confirm that free fibular epiphyseal transfer is a suitable option for reconstruction of distal radius after sarcoma resection. In addition the authors discuss the potential inferior radioulnar dissociation that may accompany such type of reconstruction. Patients and Methods: A retrospective analysis of three cases that underwent distal osteoarticular radial reconstruction using free osteo septocutaneous proximal fibular epiphyseal flaps was conducted. The data on these patients were obtained from the patients’ files, photos, and relevant radiological investigations. Results: All three cases displayed solid union, longitudinal growth (average annual rate=5mm) and hypertrophy (range: 6.6%-100%). The functional outcome for these patients was assessed according to the Enneking functional scoring system. The complications encountered were mainly fullthickness skin paddle necrosis in the case with the smallest skin paddle size (15 cm2), and inferior radioulnar subluxation (all cases). Conclusions: Free composite proximal fibular epiphyseal transfer is an optimal biological option for distal radial osteoarticular reconstruction in skeletally immature patients with potential inferior radioulnar dissociation.