Free Fibular Flap and Fibular Graft Double-Strut Tunneling to Fill a Large Tibial Plateau Defect

Area of Science:

• Orthopedic surgery
• Reconstructive surgery
• Biomaterials science

Background:

• Large bony defects in the tibia, often resulting from trauma, infection, or tumor removal, present significant reconstructive challenges.
• Free fibular flaps (FFFs) have emerged as a valuable technique for addressing long bone defects, particularly those exceeding 6 cm.

Observation:

• This article details a case involving a 60-year-old male patient with a large tibial plateau defect secondary to chronic osteomyelitis and infected nonunion.
• The patient underwent a reconstructive procedure utilizing a free fibular flap combined with a fibular graft, employing a double-strut tunneling technique.

Findings:

• The combined free fibular flap and graft double-strut tunneling successfully reconstructed the extensive tibial plateau defect.
• This case demonstrates the efficacy of FFFs in treating complex defects arising from chronic osteomyelitis and infected tibial plateau nonunion.

Implications:

• The findings suggest an expanded application for free fibular flap techniques in managing challenging long bone defects.
• This reconstructive approach holds promise for improving outcomes in patients with severe bone loss due to infection and nonunion.