Tibialization of fibula for reconstruction of big tibial defects (post-traumatic, post-infective) by Ilizarov technique

Abstract

Purpose: The purpose of this study was to evaluate the functional results of Tibialization of fibula for reconstruction of big tibial defects. Methods: Between January 2000 and January 2018, 28 patients (20 males and 8 females) with big defects following infection and post traumatic injury of the tibia were treated. The mean age of the patients at the time of surgery was 15.3 years (4-24 years). The fibula was mobilized medially to fill the defect and was fixed with Ilizarov fixator. The average size of the defects reconstructed was 7.35 cm (6-10cm). Patients were evaluated functionally using the ASAMI scoring system. Results: The mean follow-up period was 29.03 months (range, 15-60). The average time for complete union was 6.8 months (range, 5-9 months). At final follow-up all patients had fully united. We found leg length discrepancy in 22 patients and that was corrected by re- lengthening of the solid new regenerate bone. Conclusion: Ipsilateral fibular centralization or medialization is an excellent reconstruction for big tibial defects after wide debridement with very good acceptable functional outcome. Absolute stable osteosynthesis by biocompatible thin wires with Ilizarov fixation is the key to union and success.