Fibula bone grafting in infected gap non union: A prospective case series

Abstract

Infected gap non union may be result of osteomyelitis or compound fractures. This is always a challenge for the surgeon. The incidence varies widely. Ilizarov’s technique is one of the options available, which is a time taking, cumbersome procedure and needs an expert. We performed fibula grafting as a 2 staged procedure. First is debridement with external fixation, followed by fibula grafting to bridge the gap. Methods: 11 patients were enrolled in the study with infected gap nonunion. With average followed up of 14 months. Procedure i. First a through debridement and external fixator under appropriate antibiotic cover ii. After infection is controlled fibula grafting to birch the gap fixed with cortical screws, external fixator is retained till the wound heels, iii. Fixator is removed and cast immobilization for another 2 weeks iv. Removal of cast, non-weight baring exercises for 2 weeks v. Partial weight baring with crèches Conclusion: Fibula bone grafting is a good option for infected gap nonunion. We achieved good results in 80% of the patients at our setup. This method is less time consuming and less demanding as compared to Ilizarov. /div>