Abstract
Gap bone defect is a major challenge. Its treatment has evolved over the years from amputation to limb reconstruction through vascularised graft, distraction osteogenesis and use of customised implants. Availability and affordability of these innovative techniques have always been an additional challenge in the developing resource poor countries. We report the use of Tibialization of Ipsilateral fibula first suggested by Hahns in 1884 to bridge a gap of 12 cm in an 8 year old male, with segmental tibia loss from chronic osteomyelitis. We did an end to end transposition of the ipsilateral fibular into the tibia gap defect in a one stage procedure. This was after eradication of the infective process of osteomyelitis. He commenced partial weight bearing ambulation in cast at 3 months and out of cast ambulation at 18 months post surgery. The transposed fibula was 75% tibialized at 18 months post surgery. Conclusion: Fibular is a useful armamentarium in filling segmental bone defect.
Highlights
Bone gap defect is a known complication of chronic osteomyelitis
Gap non union is a known complication of chronic osteomyelitis
These 3 factors are implicated in this case .The first sequestrectomy before presenting to our facility and the subsequent repeat sequestrectomy contributed in widening the bone gap (Figures 1(a)-(c))
Summary
Bone gap defect is a known complication of chronic osteomyelitis. (2015) Tibialization of Fibula in Treatment of Major Bone Gap Defect of the Tibia: A Case Report. While Huntington did a side to side apposition, tuli et al used an end to end apposition which is less liable to fracture due to the graft being in line of the tibia mechanical axis This is a case report of an 8-year-old child with 12 cm right tibia gap defect following chronic osteomyelitis. Our choice of fibula pro tibia graft was the most viable option at the time considering the very short and poor bone quality of the proximal stump as well as the limited resources in our sub urban rural environment
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call