title: A free vascularized tibia-fibular composite graft for the traumatic femoral bony defect of a 6-year-old boy with 10-year follow up: a case report.
abstract: BACKGROUND
  Free vascularized fibular grafts have been widely used for the reconstruction of long bone defects. However, the use of a vascularized tibial graft is precluded by its weight-bearing function and unacceptable donor site morbidity.
  
  
  METHODS
  We present a rare case of using a vascularized tibia-fibular composite graft taken from a 6-year-old Chinese boy's ipsilateral lower leg to reconstruct a large bony defect of his traumatic femur. Hypertrophy of the tibial graft, good remodeling of the femoral shaft, and atrophy of the unloaded fibular graft were noted at the 10-year follow up. He was able to participate in outdoor activities such as basketball while wearing his prosthesis.
  
  
  CONCLUSIONS
  The 10-year follow up demonstrates the feasibility of this salvage procedure for a floating knee injury with neurovascular compromise.
authors.affiliation: Department of Orthopedics, Kaohsiung Municipal Hospital, No,976, Jhonghua 1st Rd,, Gushan Dist,, Kaohsiung City 804, Taiwan. orthowong2@gmail.com.
authors.forename: Shih-Hao
authors.initials: SH
authors.lastname: Chen
authors.forename: To
authors.initials: T
authors.lastname: Wong
authors.forename: Ming-Chung
authors.initials: MC
authors.lastname: Yeh
authors.forename: Chun-Huang
authors.initials: CH
authors.lastname: Pai
authors.forename: Jih-Yang
authors.initials: JY
authors.lastname: Ko