title: Tibial reconstruction by ipsilateral vascularized fibular transfer.
abstract: Between 1979 and 1991 ipsilateral vascularized fibular transposition was performed on eight patients with segmental tibial defects following injury. We report these cases with a minimum follow-up of 2.5 years. All the tibial defects were the result of severe open fractures (Gustilo Grade III) and either bone loss or infected non-union, and ranged in size from 1 to 12 cm. The patients had an average of seven procedures and a delay of 33 months before fibular transfer. The procedure was successful in achieving fracture union in all cases, with an average time to union of 15 months (range, 5-33 months). Shortening of up to 3 cm and some residual ankle stiffness was found, but all patients were ambulating bearing full weight and six had returned to their previous occupation by their final follow-up. Only one patient had significant pain affecting function. This is a successful and relatively simple technique compared to microvascular and bone transport procedures for reconstructing segmental tibial defects with relatively avascular graft beds.
authors.affiliation: Department of Orthopaedic Surgery, Derbyshire Royal Infirmary NHS Trust, Derby, UK.
authors.forename: M Z
authors.initials: MZ
authors.lastname: Khan
authors.forename: N D
authors.initials: ND
authors.lastname: Downing
authors.forename: A P
authors.initials: AP
authors.lastname: Henry
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005360:Fibula / Q000637:transplantation; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome