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Chapter-20 Tibialization of Fibula for Mangled Leg

BOOK TITLE: Neglected Musculoskeletal Injuries

Author
1. Aggarwal Anil K
2. Tuli Surendra Mohan
3. Singh Arun Pal
ISBN
9788184488890
DOI
10.5005/jp/books/11171_20
Edition
1/e
Publishing Year
2011
Pages
5
Author Affiliations
1. Chacha Nehru Bal Chikitsalya, Delhi, India
2. Vidyasagar Institute of Health and Neurosciences (VIMHANS), New Delhi, India
3. University College of Medical Sciences, Delhi, India, 2221, 48-C, Chandigarh, Bharati Vidyapeeth Deemed University Medical College and Hospital, Sangli, Maharashtra, India
Chapter keywords

Abstract

Infected gap non unions of tibia following open injuries or diaphyseal sequestration in patients with uncontrolled osteomyelitis, create immense disability for patients. With the presence of unhealthy skin or scarred and adherent tissue, discharging sinuses and persistent infection, the conventional bone grafting techniques often fails. Options available for treatment of such patients include Papineau-type bone grafting, non vascularized fibular graft, micro vascularized fibular transfer and Ilizarov’s technique. Tibialization of the fibula provides an alternative reconstruction method to salvage the limb. It involves aligning and fixing the fibula to the tibia and providing a sound mechanical and biological mechanism of weight bearing and union. The ipsilateral fibula is transferred to the tibia as a pedicled graft based on peroneal and anterior tibial muscles and peroneal artery in one or two staged procedure. The authors describe the indication of this procedure and various methods to achieve tibialization of fibula with possible complication.

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