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Immediate ipsilateral fibular transfer in a large tibial defect using a ring fixator. A case report

 H. S. Kim  ;  J. S. Jahng  ;  D. Y. Han  ;  H. W. Park  ;  C. H. Chun 
 INTERNATIONAL ORTHOPAEDICS, Vol.22(5) : 321-324, 1998 
Journal Title
Issue Date
Adult ; Fibula/transplantation* ; Fracture Fixation/methods* ; Humans ; Male ; Orthopedic Fixation Devices* ; Tibial Fractures/surgery* ; Transplantation, Autologous
Massive segmental bony defects in open tibial fractures are generally treated with conventional bone grafting, a free vascularised fibular graft or the ring fixator technique. A vascularised fibular graft may be superior to a conventional bone graft, but it is technically difficult and occasionally impossible. In such circumstances, fibular transfer in conjunction with a ring fixator is an alternative method. This procedure can be accomplished by transferring the osteotomised part of the fibula to the tibia by means of olive wires. The authors have treated a 20-year-old male who presented with a Gustilo type IIIB open tibial fracture. The soft tissue defect was severe, only the tibialis posterior artery was patent and the peroneal artery was partially damaged. A latissimus dorsi flap was performed to cover the soft tissue defect. Since the patent tibialis posterior artery had already been used for the flap, it was difficult to perform a vascularised fibular graft. Moreover, it was technically difficult to accomplish a gradual transport using a ring fixator because the distal tibia was lost. For this reason, the fibular transfer was performed immediately after the ring fixator was applied. Good bony union and fibular hypertrophy were obtained even though these two procedures were undertaken simultaneously.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
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