Objectives: We present a case report of a patient with massive segmental
loss of the tibia after hypotrophic nonunion of the tibia treated with medial transport of a hemifibula using an Ilizarov frame
Methods: Debridement and excision of bone at the site of hypotrophic nonunion left a tibial bone gap of 13 cm. Because the fibula was hypertrophied and the fibular thickness was more than that of the lost part of the tibia, hemifibular bone was used for filling the tibial defect by Ilizarov frame After 1 yr, radiographs showed hypertrophy of the transported hemifibula. An Ilizarov frame was applied to lengthen the tibia
Results: At the latest follow-up, 10 yr after the beginning of treatment (27 yr), the patient was fully weight-bearing with equal length of both legs and corrected deformity. Range of motion of the knee was normal with a limitation of the last5 degrees of plantarflexion and dorsiflexion of the ankle. Radiographs showed hypertrophy of the transported hemifibula, complete bone consolidation at the sites of medial transport and tibial lengthening, correction of the deformity, normal knee and ankle joint alignment.
Conclusions: We conclude that medial transport of the hemifibula in
selected patients is a reasonable alternative for the treatment of massive tibial defects