[Clinical and roentgenologic changes after fibula resections: causes, differential diagnostic aspects, consequences]

This study correlates the clinical and radiological development of twelve patients with resection of the fibula, with the results of experimental investigations, reporting on the loss of tension-banding and proportional weight-bearing after fibula resection. Five patients underwent segmental fibula resection because of tumour disease, seven patients by reason of harvesting an intercalary allograft. Five patients suffered from lower leg pain. Spindle-shaped thickenings of the tibial cortex could be confirmed by most x-rays, in one case the tibial shaft diameter increased up to 10%. Usually the rest of the fibula will become atrophic in grown-up patients; in children the fibula may restore completely if the preparation is performed by sparing the periosteum. Three patients suffered a stress fracture of the tibia. As pain and tibial stress fracture appeared mainly if the remaining fibula was less than 1/4th of the original fibula length, the distal part should be preserved longer if justifiable from an oncological point of view. The knowledge about basic biomechanical behaviour and the arising possibility of a stress fracture or other structural changing of the tibia after fibula resection is important for correct assessment of the postoperative clinical and radiological development.