Between October 1983 and August 1998, 31 patients with non-union or bone defect of the tibia have undergone 32 vascularized fibula transfers to reconstruct lower legs. Of these 32 vascularized fibula transfers, there were 19 pedicle transfers from the ipsilateral leg. There were 17 males and two females. The average patient age was 53 (21 to 84) years old. All patients achieved good bone reconstruction. All patients are currently able to walk without a brace, except for one. As to major complications, three of these 19 had delayed union, with only one postoperative fracture. In the cases with delayed union or fractured grafted fibulas, the periods to walking without a brace were longer than in the cases without such major complications. From the results, the ipsilateral pedicle vascularized fibula graft appears to be a useful option for reconstruction of tibial defects.
Age-related changes in proteoglycans of human ligamentum flavum were studied using specimens obtained from patients divided into four age groups. The pratenglycans ware purified by ion-exchange and gel-filtration chromatography. A low-molecular-weight proteoglycan with the same molecular size was present in all each age groups. Conversely, high-molecular-weight proteoglycan increased with advancing age. Properties of the sugar chains, glycosaminoglycans, in these proteoglycans were studied using cellulose acetate membrane electrophoresis and chondroitinase digestion, It was found that the high-molecular-weight proteoglycan consisted mainly of chondroitin 6-sulfate, whereas the low-molecular-weight proteoglycan consisted mainly of dermatan sulfate, although the ratio of chondroltin 6-sulfate increased with age. These results indicate that proteoglycans of human ligamentum flavum show changes in amount and composition with age.
