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Fibula-pro-tibia transfer with external fixator after tibia fracture with extensive bone defect: a case report
F Verdoni1, D Compagnone2, F Grasso2
1IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Summary
A tibial fracture with a large bone defect was treated with a fibula-pro-tibia transfer, which failed. A second surgery using the fibula wedged with an external fixator achieved bone healing and remodeling.
Area of Science:
- Orthopedic surgery
- Trauma reconstruction
- Bone defect management
Background:
- A 27-year-old female patient sustained a significant tibial fracture with an extensive bone defect following major trauma.
- Initial treatment involved a plate for fibula-pro-tibia transfer, which proved unsuccessful.
Observation:
- Radiographic follow-up at one year revealed non-union secondary to mechanical hardware failure.
- A subsequent surgical intervention was performed, involving the ipsilateral fibula being secured between the proximal and distal tibia using an external fixator.
Findings:
- The reconstruction demonstrated successful bone healing and remodeling over a one-year follow-up period.
- Further ossification of the fibula's periosteal sheath was observed, indicating robust regenerative capacity.
Implications:
- This case highlights the potential of fibular autografting with external fixation for managing complex tibial non-unions with extensive defects.
- The technique may offer a viable alternative for limb salvage in severe trauma cases, promoting bone regeneration and functional recovery.
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