Inter-tibiofibular graft for traumatic segmental bone defect of the tibia

• Published in: Orthopaedics & traumatology, surgery & research Vol. 98; no. 2; pp. 214 - 219
• Main Authors: Fitoussi, F, Masquelet, A.-C, Rigal, S, Poichotte, A, Bauer, T, Fabre, A
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-04-2012
• Subjects: Adolescent; Adult; Aged; Bone graft; Bone healing; Bone reconstruction; Bone Transplantation - methods; Child; Fibula - transplantation; Follow-Up Studies; Fracture Fixation, Internal - methods; Fracture Healing; Humans; Inter-tibiofibular graft; Middle Aged; Orthopedics; Prognosis; Radiography; Reconstructive Surgical Procedures - methods; Retrospective Studies; Segmental bone defect; Surgery; Tibia - diagnostic imaging; Tibia - injuries; Tibia - surgery; Tibial Fractures - diagnostic imaging; Tibial Fractures - physiopathology; Tibial Fractures - surgery; Time Factors; Treatment Outcome; Weight-Bearing; Young Adult; Bone reconstruction; Bone healing; Bone graft; Inter-tibiofibular graft; Segmental bone defect
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2012.01.002

Summary Introduction The present study sought to assess the interest of inter-tibiofibular graft (ITFG), alternatively called posterolateral bone graft, in traumatic segmental tibial bone defect. Material and methods Twenty-eight ITFGs were performed in 125 tibial reconstructions for traumatic bone defect. Patient's records were reviewed retrospectively in a multicenter study. Tibial reconstruction with and without ITFG was compared for bone healing and patient's return to full weight-bearing status. Results There were no failures of bone healing in the ITFG group, versus 14 (14%) in the non-ITFG group. Graft-to-consolidation delays were shorter with first-line ITFG, at a mean 10 months (range, 3–20 months) versus 16.5 months (range, 3–63 months) in the non-ITFG group ( P < 0.05). Weight-bearing was likewise more quickly resumed, with full weight-bearing at a mean 9 months (range, 3–19 months) versus 15 months (range, 1–34 moths) respectively ( P < 0.05). Return to work was also quicker, at a mean 15 months (range, 4–28 months) versus 27 months (range, 8–56 months) respectively ( P < 0.05). Discussion This study confirmed the interest of ITFG in tibial bone defect reconstruction. ITFG may singly be used for small defects less than 4 cm, or in conjunction with another tibial reconstruction technique; ITFG in the present series achieved consolidation in all cases and significantly shortened the times to return to full weight-bearing status and to work. Level of evidence III: retrospective case-control study.