Treatment of large diaphyseal bone defect of the tibia by the "fibula pro tibia" technique: application in developing...

Large segmental bone defects of the tibia may be due to infections, high-energy fractures, congenital diseases or tumors and represent a challenge for both the physician and the patient. In developing countries, the use of expansive techniques is not possible so that amputation is sometimes proposed. However, an alternative technique for limb salvage, applicable in developing countries consists of tibialization of the ipsilateral fibula. This technique is also called "Fibula pro Tibia", fibular transfer to the tibia or fibular centralization. We report this transfer in 4 patients with an average defect length of 11.8 cm. Union between the transferred fibula and the tibia was obtained in all patients, for both proximal and distal junctions, after an average time of 8.5 months (range, 4 to 18 months). Three patients returned to a normal walking function while one was still limping, but was able to walk independently without need of crutches.