Abstract

Summary A severe tibial bone loss with damage to soft tissue and neurovascular supply is a very challenging injury for orthopaedic surgeons. Cases of severe injuries with wide bone loss, which demanded amputation in the past, can be salvaged by surgical techniques such as segmental bone transport, autograft or allograft transplantation and microsurgery. Owing to its rich soft tissue coverage, the fibula can be used in limb salvage operations as a vascularized strut graft. We present here three cases of young patients with severe tibial bone loss who underwent complex surgical procedures for limb salvage in which the fibula played a central role. The long-term follow-up showed complete ‘tibialization' of the fibula, which replaced the missing tibia, becoming a tibia for all purposes.

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