Comparision of non-vascularized fibular graft as an intramedullary strut v/s conventional bone grafting for management of nonunion of long bones

Abstract

Objective: The purpose of our study is to describe our experience with the non-vascularised fibular autogenous grafts that was used for the treatment of nonunion of long bones including tibia, femur & humerus and to analyse and compare the results in terms of postoperative wound infection, radiographic evidence of union, postoperative pain and functional disability, success rate of procedure etc. with conventional iliac crest bone grafting and plating, at a tertiary care centre.Methods: The study was conducted in department of Orthopedics SMSMC, Jaipur from September 2017 to June 2019 and included 80 cases of nonunion of long bone. Amongst these, 40 cases were treated with fibular strut grafting and 40 cases were treated with iliac crest bone grafting, and all cases were followed postoperatively to compare the results in terms of demographic parameters, union time, postop complications.Result: Amongst 32 cases of nonunion of long bones treated with fibular strut 31 cases (96.9%) showed complete union in mean time interval of 17.77 weeks while only 29 (85.3 %) amongst 34 cases treated with iliac crest bone graft showed union in mean time of 18.41 weeks.Graft site pain was noted in 20.6% cases of iliac crest graft while no cases of fibular strut graft had this problem; EHL weakness was noted in 34.4% of cases and all of them recovered fully at the end of follow up.Conclusion: According to our study fibular strut is a better option in treatment of nonunion long bones as maximum cases showed complete union in less time interval and with very few postoperative complications than iliac crest bone grafting.