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Case Reports
. 2010 Mar;34(3):425-30.
doi: 10.1007/s00264-009-0761-x. Epub 2009 Mar 24.

Free vascularised fibular grafting in the treatment of large skeletal defects due to osteomyelitis

Yuan Sun  1 , Changqing Zhang, Dongxu Jin, Jiagen Sheng, Xiangguo Cheng, Xudong Liu, Shengbao Chen, Bingfang Zeng
Affiliations
Case Reports

Free vascularised fibular grafting in the treatment of large skeletal defects due to osteomyelitis

Yuan Sun et al. Int Orthop. 2010 Mar.

Abstract

Treatment of skeletal defects secondary to osteomyelitis is a challenging problem. The purpose of this study was to present our experience of the use of free vascularised fibular grafts to treat such defects. Ten patients with a mean age of 31 years (range 16-50 years) and a skeletal defect with a mean length of 9.5 cm (range 6-17 cm) were managed with a protocol which included radical debridement of the lesion and a vascularised fibular graft. The mean follow-up time was 26 months. Union of the graft occurred in all patients, at a mean of 4.5 months. No recurrence of osteomyelitis was observed. The mean time to full weight bearing was ten months, and all patients were pain-free and able to walk without supportive devices. A free vascularised fibular graft is a viable option for the management of large skeletal defects resulting from osteomyelitis.

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Figures

Fig. 1
Fig. 1
a Roentgenograms on referral. b Roentgenograms after our debridement showed a 9-cm tibial defect. A microvascular fibular transfer with locking compression plate (LCP) was performed to reconstruct the tibial bone defect. c Roentgenograms after 4 months showed good union of the grafted fibular bone. d Roentgenograms after 2 years showed good hypertrophy of the grafted fibular bone
Fig. 2
Fig. 2
a Roentgenograms before surgery. b Roentgenograms after first internal fixation c Roentgenograms after 10 months showed nonunion. Debridement and artificial bone graft were performed. d After 4 months roentgenograms showed that artificial bones were absorbed. e Anteroposterior and lateral radiographs postoperatively showing free vascularised fibular grafts combined with locking compression plate (LCP). f Anteroposterior and lateral radiographs at 7 months showing the solid union of the graft
See this image and copyright information in PMC

References

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