Autologous Fibular Strut Graft as a Substitute for Iliac Crest Graft and Bone Substitutes or Implant in Opening Wedge Valgus Tibia Osteotomy in Children

Abstract

Genu varum deformity in children remains a major worry for parents. Children with pathologic genu varum deformities usually undergo corrective osteotomy to correct the deformity. Several methods of osteotomy which include closing wedge lateral tibial osteotomy, dome osteotomy, opening wedge medial osteotomy have been employed. Objective: Objective of the study was to determine the usefulness of autologous fibular strut graft as a substitute for other iliac crest graft, bone substitutes and implants as graft to fill the void and maintain the patency of the open wedge and correction. Methods Seventeen children underwent opening wedge osteotomy and the ipsilateral fibular strut was harvested to maintain patency of the open wedge and fill the void. Result 15 of the 17 children had their deformities corrected with radiological union showing callus which incorporated the strong fibular strut in serial radiograghs.at 6weeks and 12weeks. All expect 2 children bore full weight at 16 weeks with satisfactory correction of the deformity. One patient has deep infections and opted for another referral facility at 16 weeks. Conclusion: Autologous fibular strut graft is a very good if not a better graft for open wedge medial tibial osteotomy due to its strength, durability in maintaining correction, its cost effectiveness, the convenience of graft harvest and limited sites of wound and pain.