Ipsilateral vascularised fibula with external locking plate for treatment of massive tibial bone defects

Ching Hou Ma, Yen Chun Chiu, Chin Hsien Wu, Kun Ling Tsai, Tsung Kai Wen, Yuan Kun Tu

研究成果: Article同行評審

摘要

Introduction: Management of massive tibial bone defects remains challenging for orthopaedic doctors. This study aimed to ascertain the viability and reliability of utilising an ipsilateral vascularised fibula with an external locking plate for the difficult situation. Materials and methods: Between January 2012 and December 2017, eight patients (7 men) with a mean age of 32.3 (19-54) years who presented with massive tibial bone defects were treated using the described technique. The mean length of the bone defect was 12.4 (8-20) cm. The patients were assessed for clinical and radiographic results, hypertrophy of the fibular graft with DeBoer and Wood's method, and SF-36 functional score. Results: The mean follow-up period was 40.3 (26-60) months. The average time for union was 5.6 (3-8) months. At the final follow-up, all patients had fully united grafts and walked without restriction. The mean graft hypertrophy index was 98.2 %. The SF-36 score was > 75 % in five patients, and 50-75 % in three. Three patients had a leg length discrepancy of > 1.5 cm. Two patients with equinus foot were treated using tibiotalocalcaneal fusion. Three patients had pin-tract infections. Four screws were broken in two cases. Conclusion: Ipsilateral vascularised fibular transfer combined with an external locking plate as a definitive external fixator provides a simple and comfortable treatment, and appropriate mechanical loading and vascularisation of the graft site to achieve hypertrophy of the fibular graft. Hence, our technique can serve as a valuable alternative for the treatment of massive tibial bone defects.

原文English
頁(從 - 到)1629-1634
頁數6
期刊Injury
52
發行號6
DOIs
出版狀態Published - 2021 六月

All Science Journal Classification (ASJC) codes

  • 急診醫學
  • 骨科和運動醫學

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