O2017 TIBIAL GAP FRACTURES RECONSTRUCTED BY IPSILATERAL VASCULARISED FIBULAR TRANSFER

Abstract

Aim: To review the effectiveness of ipsilateral þbular transfer with its vascular pedicle mobilised in bridging defects in the tibial shaft. Method & Results: This operation was performed in 8 patients with segmental tibial defect following injury. We reviewed these cases with a minimal 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 þbular 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 þnal follow up. Only one patient had signiþcant pain affecting function. Conclusion: This is a successful and relatively simple method of reconstructing segmental tibial defects with relatively avascular beds, and avoids the problems of tibial transport and of microvascular anastomoses.