Published 20-09-2021
Keywords
- Bridge graft,
- , fibular graf,
- tibia nonunion,
- bone graft
Copyright (c) 2021 The Planet
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
Abstract
Background: Non-union is an inevitable consequence in many circumstances of compound distal tiabial fracture. In many recent research papers, now-a-days, it has been claimed that bridge graft with fibula is good treatment option for management of such cases of non-union in clinical situations with distal tibial fracture. Methodology: This prospective study was conducted with a toal number of 12 patients with non-infected distal tibial non-union were treated with fibular graft technique from October, 2014 toSeptember 2020 in Khulna Medical College Hospital and in private hospitals. To select sample, convenient purposive sampling was used. Results: Among the study population, 58.3% (07) patients were male. 33.3% (04) of male patients were in 30-40 years age group, whereas in female patients, majority of the patients (25%) were in 40-50 years age group. Road traffic accident was found as the commonest mode of injury in 50% (06) patients of distal tibial fracture. Gustilo-Anderson grade IIIA was the most
common type (58.3%). Excellent outcome was observer in 75% (09) patients. In 58.3% (07) patient, there was no chronic pain in follow-up. However, chronic pain at donor site was found in approximately 33.3% (04) patients. Only in 1 patient (8.3%) persistent chronic pain was observed donor site. Healing occurred fairly by primary intention in 83.3% (10) patients, whereas in 16.7% (02) patients, healing occurred by secondary intention. Overall in 75% (09) patients, no obvious complication was observed. Refractory complication was observed in only 1 patient (8.3%). Conclusion: Bridge graft with fibula for managing distal tibial non-union is
aresilient treatment option with fewer and manageable complications.
References
- Audigé L, Griffin D, Bhandari M, Kellam J, Rüedi TP. Path analysis of factors for delayed healing and nonunion in 416 operatively treated tibial shaft fractures. ClinOrthopRelat Res. 2005;438:221–32.
- Hak DJ. Management of aseptic tibial nonunion. J Am AcadOrthop Surg. 2011;19(9):563–73.
- Reckling FW, Waters CH., 3rd Treatment of non-unions of fractures of the tibia diaphysis by posterolateral cortical cancellous bone-grafting. J Bone Joint
- Surg Am. 1980;62(6):936–41.
- Megas P, Panagiotopoulos E, Skriviliotakis S, Lambiris E. Intramedullary nailing in the treatment of aseptic tibial nonunion. Injury. 2001;32(3):233–9.
- Oh JK, Bae JH, Oh CW, Biswal S, Hur CR. Treatment of femoral and tibialdiaphysealnonunions using reamed intramedullary nailing without bone graft. Injury. 2008;39(8):952–9.
- Phieffer LS, Goulet JA. Delayed unions of the tibia. J Bone Joint Surg Am. 2006;88(1):206–16.
- James CW, Santrock RD. Poster presented at the Advances in Foot and Ankle Surgery Course. New York, NY: 2008. Dec 5-6, Reconstruction of distal
- tibialnonunions: fibular bridge technique.
- Sharma S, Devgan A, Marya KM, Rathee N. Critical evaluation of Mangled extremity severity scoring system in Indian patients. Injury. 2003 Jul;34(7):493-6.
- Gustilo RB, Merkow RL, Templeman D. The management of open fractures. J Bone Joint Surg Am. 1990 Feb;72(2):299-304.
- Amitava NM, Ananda KP, Debashis S, Debadyuti B, Chinmoy N, Harvesting the free fibular graft: A modified approach; Indian J Orthop. 2011 Jan-Mar; 45(1): 53–56.
- Milch H. Synostosis operation for persistent non-union of the tibia: a case report. J Bone Joint Surg. 1939;21:409–13.
- Kassab M, Samaha C, Saillant G. Ipsilateral fibular transposition in tibial nonunion using Huntington procedure: a 12-year follow-up study. Injury. 2003
- Oct;34(10):770–5.
- Oren D, Sapir O, Stern A, Nyska M. Ipsilateral fibular transfer for a large tibial defect caused by a gunshot injury: case report. Mil Med. 2005;170(5):418–
- Shapiro MS, Endrizzi DP, Cannon RM, Dick HM. Treatment of tibial defects and nonunions using ipsilateral vascularized fibular transposition. ClinOrthopRelat Res. 1993;296:207–12.