Strategies in Trauma and Limb Reconstruction

Register      Login

VOLUME 6 , ISSUE 3 ( November, 2011 ) > List of Articles

CASE REPORT

Treatment of a fibular autograft non-union with a resulting deformity by stabilization, progressive correction and callotasis using an Ilizarov fixator: a case study

Yasser Elbatrawy, Giby C. Philips

Keywords : Ilizarov, Tumour, Graft, Osteosarcoma, Bone defect, Reconstruction, Deformity correction

Citation Information : Elbatrawy Y, Philips GC. Treatment of a fibular autograft non-union with a resulting deformity by stabilization, progressive correction and callotasis using an Ilizarov fixator: a case study. 2011; 6 (3):167-171.

DOI: 10.1007/s11751-011-0106-3

License: CC BY-NC-SA 4.0

Published Online: 01-12-2012

Copyright Statement:  Copyright © 2011; The Author(s).


Abstract

Bone tumours present a challenge to reconstructive surgery when the tumour breaches the physeal and periphyseal region of the growing bone. Though a host of options are available, these are not without complications. We report one such case of osteosarcoma of the tibia treated initially with wide resection of the tumour and intercalary fibular strut grafting using plate and screws. The operation was complicated by a non-union at the proximal tibio-fibular autograft junction. This leads to a multiplanar deformity with severe procurvatum at the proximal tibio-fibular graft junction, which was successfully treated by callotasis using an Ilizarov fixator. Appropriate consent was obtained from the patient and parents to publish this case report.


PDF Share
  1. Green SA (1994) Skeletal defects. a comparison of bone grafting and bone transport for segmental skeletal defects. Clin Orthop Relat Res 301:111-117
  2. Christian EP, Bosse MJ, Robb G (1989) Reconstruction of large disphyseal defects, without free fibular transfer, in grade 111-B tibial fractures. J Bone Joint Surg Am 71:994-1004
  3. Weiland AJ (1981) Current concepts review: vascularized free bone transplants. J Bone Joint Surg Am 63:166-169
  4. DeCoster TA, Gehlert RJ, Mikola EA, Pirela-Cruz MA (2004) Management of posttraumatic segmental bone defects. J Am Acad Orthop Surg 12(1):28-38
  5. Weiland AJ (1984) Vascularized bone transfers. Instr Course Lect 33:446-460
  6. Sowa DT, Weiland AJ (1987) Clinical applications of vascularized bone autografts. Orthop Clin North Am 18:257-273
  7. Brown KL (1991) Limb reconstruction with vascularized fibular grafts after bone tumor resection. Clin Orthop Relat Res 262:64-73
  8. Hertel R, Pisan M, Jacob RP (1995) Use of the ipsilateral vascularized fibula for tibial reconstruction. J Bone Joint Surg Br 77:914-919
  9. Chacha PB, Ahmad M, Daruwalla JS (1981) Vascular pedicle graft of the ipsilateral fibula for non-union of the tibia with a large defect. an experimental and clinical study. J Bone Joint Surg Br 63-B:244-253
  10. Koulouvaris P, Theos C, Kottakis S, Demertzis N (2007) A simple treatment for a 15 cm tibia bone defect: a case report of an ipsilateral vascularized fibula transfer. J Orthop Trauma 21(3):215-218
  11. Agiza AR (1981) Treatement if tibial osteomyelitic defects and infected pseudoarthrosis by the Huntington fibular transference operation. J Bone Joint Surg Am 63:814-819
  12. Kassab M, Samaha C, Saillant G (2003) Ipsilateral fibular transposition in tibial nonunion using Huntington procedure: a 12 year follow-up study. Injury 34(10):770-775
  13. Mohler DG, Yaszay B, Hong R, Wera G (2003) Intercalary tibial allografts following tumor resection: the role of fibular centralization. Orthopedics 26(6):631-637
  14. Shapiro MS, Endrizzi DP, Cannon RM, Dick HM (1993) Treatment of tibial defects and nonunions using ipsilateral vascularized fibular transposition. Clin Orthop Relat Res 296:207-212
  15. Springfield D (1996) Autograft reconstructions. Orthop Clin North Am 27(3):483-492
  16. Lee EH, Goh JC, Helm R, Pho RW (1990) Donor site morbidity following resection of the fibula. J Bone Joint Surg Br 72(1):129-131
  17. Mooney V, Nickel VL, Harvey JP Jr, Snelson R (1970) Castbrace treatment for fractures of the distal part of the femur. a prospective controlled study of one hundred and fifty patients. J Bone Joint Surg Am 52(8):1563-1578
  18. Ostrum RF, Geel C (1995) Indirect reduction and internal fixation of supracondylar femur fractures without bone graft. J Orthop Trauma 9(4):278-284
  19. Aronson J (1997) Limb-lengthening, skeletal reconstruction, and bone transport with the Ilizarov method. J Bone Joint Surg Am 79(8):1243-1258
  20. Cierny G III, Zorn KE (1994) Segmental tibial defects. comparing conventional and Ilizarov methodologies. Clin Orthop Relat Res 301:118-123
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.