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Chronic Osteomyelitis With Pathologic Tibia Fracture: Debridement and Fibular Tibialization in a Developing Country:
G Dillon Graham1, Ainsley Bloomer1, Johnson Mbise2
1Atrium Health Musculoskeletal Institute; Charlotte, North Carolina.
JBJS Case Connector
|August 11, 2026
Summary
Fibular tibialization successfully treated chronic tibial osteomyelitis in a pediatric patient with significant bone loss. This limb salvage technique offers a viable alternative when bone grafting is not feasible.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Pediatric Orthopedics
Background:
- Chronic tibial osteomyelitis presents a significant challenge in pediatric patients.
- Extensive bone loss can limit treatment options, often necessitating amputation.
Purpose of the Study:
- To evaluate the efficacy of fibular tibialization as a limb salvage procedure.
- To report a case of chronic tibial osteomyelitis treated with fibular tibialization.
Main Methods:
- A 22-month-old female with chronic tibial osteomyelitis underwent debridement of a 10-cm necrotic tibia.
- Culture identified Proteus mirabilis; treatment included IV and oral antibiotics.
- Fibular tibialization with K-wire fixation was performed, followed by a course of antibiotics.
Main Results:
- Postoperative radiographs demonstrated early callus formation at six weeks.
- The patient achieved full healing with complete knee and ankle range of motion at one year.
- No residual pain or complications were reported.
Conclusions:
- Fibular tibialization is a feasible and effective salvage option for pediatric patients with substantial tibial bone loss.
- This technique provides a valuable alternative to amputation when bone grafting or transport is not viable.
