在本文中，作者们介绍了一种改良的平行重建血管化腓骨自体移植（VFA）的方法，用于股骨移植物并发症的病例。常规的平行重建方法将带有其血管蒂的腓骨放置在股骨和异基因骨的内侧，可能是解决股骨移植物并发症的有效手段。然而，腓骨与股骨/异基因骨之间的接触面积有限，可能会影响骨愈合能力。此外，VFA的刚性内固定方法可能会导致应力屏蔽并导致骨吸收。作者们建议对于术后患有异基因骨与宿主交界部不愈合、异基因骨骨折和股骨干骨折的患者，采用改良的VFA平行重建方法，包括腓骨扩张和钛钢线固定。在5例患者中进行了改良的平行重建手术（其中2例患者进行了腓骨扩张）。对于7例异基因骨与宿主交界部不愈合或骨折的患者，随访时间为33.2个月。腓骨移植物的长度为10-20厘米，平均为15.0厘米。异基因骨与宿主交界部和骨折的愈合率为100%（7/7），愈合时间为15.9个月。这种改良的平行重建技术可在治疗上述并发症时实现令人满意的愈合。版权所有 © 2023 美国整形外科协会。

The authors herein introduce a modification of parallel reconstruction with a vascularized fibula autograft (VFA) for cases of femur allograft complications. Conventional parallel reconstruction, in which the fibula with its vascular pedicle is placed on the medial side of the femur and allogeneic bone, may be an effective means to solve the allograft complications. However, the limited contact area between the fibula and femur/allogeneic bone can affect the bone healing ability. Furthermore, the rigid internal fixation method for the VFA may cause stress shielding and result in bone resorption. The authors propose the use of modified parallel reconstruction of the VFA with fibula expansion and titanium cable fixation for patients with allograft-host junction nonunion, allogeneic bone fracture, and femoral shaft fracture after surgical removal of a malignant tumor from the thigh. The modified parallel reconstruction has been performed on 5 patients (2 patients underwent fibular expansion). All 5 patients with 7 nonunion of allograft-host junction or fracture were followed up 33.2 months. The length of fibular graft is 10-20cm, with an average of 15.0 cm. The union rate of allograft-host junction and fracture was 100% (7/7), and the union time 15.9 months. This modified parallel reconstruction technique can achieve satisfactory union in treatment of the above complications.Copyright © 2023 by the American Society of Plastic Surgeons.