Chen Shih-Hao, Wong To, Yeh Ming-Chung, Pai Chun-Huang, Ko Jih-Yang
Department of Orthopedics, Kaohsiung Municipal Hospital, No,976, Jhonghua 1st Rd,, Gushan Dist,, Kaohsiung City 804, Taiwan.
J Med Case Rep. 2013 May 28;7:136. doi: 10.1186/1752-1947-7-136.
Free vascularized fibular grafts have been widely used for the reconstruction of long bone defects. However, the use of a vascularized tibial graft is precluded by its weight-bearing function and unacceptable donor site morbidity.
We present a rare case of using a vascularized tibia-fibular composite graft taken from a 6-year-old Chinese boy's ipsilateral lower leg to reconstruct a large bony defect of his traumatic femur. Hypertrophy of the tibial graft, good remodeling of the femoral shaft, and atrophy of the unloaded fibular graft were noted at the 10-year follow up. He was able to participate in outdoor activities such as basketball while wearing his prosthesis.
The 10-year follow up demonstrates the feasibility of this salvage procedure for a floating knee injury with neurovascular compromise.