Nigerian Journal of Orthopaedics and Trauma

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Management of Bone Gaps with Intramedullary Autologous Fibular Strut Graft

OC Nwokike, JE Onuminya, E Esezobor, E Edomwonyi, DO Olomu


Introduction: Bone gap is one of the most challenging reconstructive problems that may confront an Orthopaedic surgeon. There is no consensus on the best option of treatment as every method has its pros and cons with variable results being reported. This paper presents our experience with 7 consecutive patients who presented with bone gaps that were managed with intramedullary non vascularised fibular strut graft.
Method: Intramedulary Autologous fibular strut graft was used to breach the bone and the whole length augmented with cancellous graft and bridged with bone plate; external fixators or k wires.
Result: Mean gap defect was 6.57cm and the range was 4- 12 cm. Mean total hospital stay was 18.5 days. Mean time to achieve union was 6.6 months. Five patients had union at both graft sites. Wound infections, fibrotic tissue envelopes and soft tissue contracture were problems in 4 patients. Median Post operative residual limb length discrepancy was 1.6cm.
Conclusion: It is safe to conclude that the use of non vascularised fibular strut graft is a cheap and effective armamentarium in the reconstruction of long bones with gap defects.

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