[Color Duplex Ultrasound in Monitoring Vascularized Fibula Transplants]

Background: For the successful management of vascularized free fibular bone grafts, the early detection of vascular complications is important. When vascular complications are suspected without a reliable monitoring of the graft perfusion, revision surgery often proved to be unnecessary. Color duplex sonography for the postoperative monitoring of free fibular bone grafts without a skin island is demonstrated.

Material And Methods: The quantitative and qualitative monitoring of the perfusion of microvascular anastomosis and the transplanted tissues using color duplex sonography with a 7.5-Mhz scanner (Elegra, Siemens, Germany) for the postoperative monitoring of 12 free fibular bone grafts was performed. Using color duplex sonography, the perfusion of the vascular pedicle and the free fibular bone grafts was demonstrated in all 12 free fibular bone grafts. In three patients vascular complications and failure of the bone grafts were suspected due to postoperative complications next to free fibular bone grafts such as abscess formation, wound dehiscence, and disturbances of wound healing. Using color duplex sonography, adequate perfusion of the vascular pedicle and the transplanted tissue was demonstrated and therefore revision surgery not indicated.

Discussion: Color duplex sonography is a reliable, noninvasive, and inexpensive method for the postoperative monitoring of free fibular bone grafts.