Supercharged free fibula for complex ankle arthrodesis: a case report

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Vascularized Bone Grafts

Background:

• A 28-year-old patient had prior distal tibia resection and methyl methacrylate cement spacer placement for a giant cell tumor.
• The cement spacer eroded into the ankle joint, necessitating ankle arthrodesis but leaving insufficient distal tibia bone stock.

Observation:

• A supercharged free fibula flap was utilized for distal tibia reconstruction and ankle arthrodesis.
• The fibula was transferred on its distal blood supply, with proximal vascular supply anastomosed to posterior tibial vessels.
• External fixation using an Ilizarov device was applied for stable bone healing.

Findings:

• The supercharged free fibula successfully reconstructed the tibial defect, achieving timely bony union.
• Stable external fixation facilitated bone healing and functional recovery.
• The patient regained pain-free ambulation.

Implications:

• This technique offers a viable solution for complex tibial defects where traditional bone grafting is not feasible.
• Supercharging the fibula flap enhances graft viability and promotes successful osseous integration.
• This approach avoids complications associated with alternative reconstructive methods, improving patient outcomes.