[Treatment of tibial pseudoarthrosis. Complications after intramedullary, allogeneic fibular grafting].
A 24-year-old woman underwent cosmetic bilateral tibial lengthening with severe complications. In all, 15 operations, including allogeneic fibular grafting of both tibia, were required to treat unstable bilateral non-union, malalignment, and osteomyelitis of the right tibia.The present article describes the surgical strategy of revision to achieve good recovery with full consolidation and proper alignment of the lower leg. Furthermore, the indications for allogeneic bone grafting, which was described by Erich Lexer 100 years ago, are discussed. For surgical revision, a T-external fixator was used on the right leg, while a customized tibial nail was used on the left leg. Using these techniques, full consolidation and proper alignment was achieved. Allogeneic bone grafts in upper extremity defects cannot be recommended.
Klinik für Allgemeine, Unfall-, Hand- und Plastische Chirurgie, Standort Innenstadt, Nußbaumstraße 20, 80336, München, Deutschland, tobias.helfen@med.uni-muenchen.de.
T
T
Helfen
W C
WC
Prall
W
W
Mutschler
P H
PH
Thaller
D000328:Adult; D001852:Bone Lengthening / Q000009:adverse effects*; D016025:Bone Transplantation / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D011542:Pseudarthrosis / Q000209:etiology / Q000601:surgery*; D013978:Tibial Fractures / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome