Tibialization of Fibula in Treatment of Major Bone Gap Defect of the Tibia: A Case Report

Nwokike, OC; Esezobor, Emmanuel E; Olomu, D. O.; Edomwonyi, Edwin Omon; Onuminya, J E

doi:10.4236/ojo.2015.58032

Cited by 2 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although various modifications have been made over the years, the principle remained the same. In previous similar studies, 22 Tuli 23 evaluated 21 patients with tibia gap defect due to either infection or trauma, union was obtained in all the patients. In 8 of 11 patients with tibia gap defects ranging from 4 to 22 cm due to tumour resection, trauma or chronic osteomyelitis, Kassab et al.…”

Section: Discussionmentioning

confidence: 94%

Two-stage treatment with sliding fibular flap technique for chronic infected nonunion of the tibia

Kapukaya

Çiloğlu

2020

Chinese Journal of Traumatology

View full text Add to dashboard Cite

Purpose To assess the effectiveness of two-stage treatment with the fibular sliding technique in chronic infected nonunion of the tibia. Methods The study included patients who were diagnosed with long-term chronic infected tibial nonunion following trauma and treated with the two-stage technique between January 2010 and November 2017. Patients with (1) intra-articular fractures of the distal third of the tibia and fibula, (2) pathological fracture resulting in bone loss or (3) neurological and vascular pathologies of the limbs were excluded. The operation consisted of two stages and the main goal in the first stage was to control the infection and in the second stage to control the healing of the bone. Functional & radiographic results and complications were evaluated according to Paley's criteria. Results The patients comprised 14 males and 5 females with a mean age of 37.4 years (range, 21–52 years). Patients were followed up for an average of 27 months (range, 15–38 months). The microorganisms produced from these patients were Staphylococcus aureus in 13 patients, Pseudomonas aeruginosa in 4 patients and no bacteria in 2 patients. After the first stage operation, superficial skin necrosis developed in 1 patient. In another patient, there was a persistent infection, although union was achieved. For the entire patient group, union was observed at the end of 7.44 months (range, 7–11 months). Based on Paley's criteria, there were 16 (84.2%) patients with excellent scores, 2 (10.5%) good scores and 1 (5.3%) fair scores radiologically; while regarding the tibial function, 15 (78.9%) patients had excellent scores, 3 (15.8%) good scores, and 1 (5.3%) fair scores. No patients had poor radiological or functional score. Conclusion Two-stage treatment can be considered as an alternative for fractures in regions that are susceptible to many and persistent complications, such as the tibia. This technique has the advantages of short operation time, minimal blood loss, no excessive tissue damage and not very technique-demanding (a short learning curve with no requirement for an experienced team).

show abstract

Section: Discussionmentioning

confidence: 94%

Two-stage treatment with sliding fibular flap technique for chronic infected nonunion of the tibia

Kapukaya

Çiloğlu

2020

Chinese Journal of Traumatology

View full text Add to dashboard Cite

show abstract

“…Segmental tibial defects due to any cause are rare in children and represent a challenging problem 12, 14. There are multiple etiologies for this condition, such as severe trauma, osteomyelitis, reconstruction or congenital aetiologies, such as agenesis or pseudarthrosis of the tibia 6 .…”

Section: Discussionmentioning

confidence: 99%

Massive segmental bone loss due to pantibial osteomyelitis in children reconstructed by medial fibular transport with Ilizarov frame

Zaman

Javed

Ahmad

et al. 2017

Journal of Taibah University Medical Sciences

View full text Add to dashboard Cite

Objectives Vascularized or non-vascularized fibula transport is a novel procedure for limb salvage but has been associated with high failure rates and complications. Ipsilateral medial fibular transport (IMFT) using Ilizarov apparatus is a modification of the procedure to prevent complications and increase success rate. This article presents the largest series of limb salvage for massive tibial bone loss in children due to pan-osteomyelitis by IMFT with Ilizarov apparatus. Methods A case series of 12 patients with a mean age of 12 (6–18) years is described. At the first stage of surgery, the excision of all dead bone was performed, and Ilizarov without traction apparatus was applied. In second stage, ipsilateral fibula is gradually transferred to tibial defect with the help of ilizarov olive wires. In the third stage, the freshening of docking sites of fibula to tibia was performed. The minimum follow up was of two years. Results Hypertrophy of the transported fibula accompanied by full weight bearing and satisfactory joint motion occurred in all patients. Removal of sequestrated bone resulted in control of infection in 27.17 ± 7.76 days. Fibular transport took 16.58 ± 4.14 days. The length of tibial bone loss replaced by fibula was 9.50 ± 2.23 cm. The mean days required for union after freshening of the docking site was 76.58 ± 6.20 days. Conclusions Ilizarov frame for pan tibial osteomyelitis with bone excision and medial fibular transport works well for limb salvage in children.

show abstract

Tibialization of Fibula in Treatment of Major Bone Gap Defect of the Tibia: A Case Report

Cited by 2 publications

References 16 publications

Two-stage treatment with sliding fibular flap technique for chronic infected nonunion of the tibia

Two-stage treatment with sliding fibular flap technique for chronic infected nonunion of the tibia

Massive segmental bone loss due to pantibial osteomyelitis in children reconstructed by medial fibular transport with Ilizarov frame

Contact Info

Product

Resources

About