Resumen

FERNANDEZ, Amilcar; VARGAS, María de Lourdes  y  PONTILLO, Pascual. Vascularized free fibula graft in pseudarthrosis of the tibia by a chronic osteomyelitis. Salus [online]. 2014, vol.18, n.3, pp.41-45. ISSN 1316-7138.

Fractures of the tibia are the most common in the long bones and correspond to 24% of open fractures, traffic accidents being responsible for 50%. Bone defects are the result of limb injuries with severe acute traumatic bone loss. The use of vascularized fibular grafting for severe bone defects in tibia and femur has a success rate of 61% to 91%. Clinical case: Male patient is 21 years old with a history of fracture in the mid-third right tibia and fibula who presented atrophic nonunion and bone defect, reconstructive surgery was performed using fibular osteotomy 20 cm without compromising its blood supply and is implanted within the intramedullary canal of the tibia as graft join in the proximal and distal ends, making synthesis with double-bar external fixator, maintaining alignment of the right tibia in the anteroposterior and lateral plane. Bone healing and integration of the fibula grafting was achieved at 5 months, at 8 months was external fixator removal, the patient has a residual shortening of 7 cm, which is compensated by use of the right leg up in footwear. It can be concluded that the ipsilateral peroneal vascularized graft offers wide range of security in the vascular supply to the recipient area, promoting the bone integration with the formation of a biomechanically neo tibia that provides excellent results.

Palabras clave : Nonunion; vascularized graft; osteomyelitis; bone defect.

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