Ipsilateral fibular transfer for a large tibial defect caused by a gunshot injury: case report.
Segmental bony defects in open fractures of the tibia are bridged with bone grafting, free vascularized fibular grafts, or an external ring fixator. A 33-year-old man sustained a gunshot injury to his left leg, resulting in Gustillo type IIIB open fractures of the tibia and fibula. The tibia had a segmental massive defect of 19 cm in the midshaft. Debridement and immediate application of an Ilizarov external fixator were performed. The midportion of the ipsilateral fractured fibula served as a bridging vascularized graft for the tibial defect. Good bony union and fibular hypertrophy were obtained. Use of a fractured fibula from a zone previously injured by a gunshot has not been reported. This case demonstrates the successful transfer of a fractured fibula for the bridging of an ipsilateral tibial defect caused by a gunshot injury.
Department of Orthopedic Surgery, Sapir Medical Center, Kfar-Saba, Israel.
David
D
Goren
Oleg
O
Sapir
Avraham
A
Stern
Meir
M
Nyska
D000328:Adult; D016025:Bone Transplantation / Q000379:methods; D016267:External Fixators; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries* / Q000637:transplantation*; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000601:surgery*