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Non-vascularized fibula and corticocancellous bone grafting for gap nonunion of lower limb—retrospective study of 18 cases—an age old technique revisited

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European Orthopaedics and Traumatology

Abstract

Purpose

The aim of this study was to evaluate the treatment of gap nonunion using non-vasularized fibula and corticocancellous bone grafting.

Methods

We analyzed 18 patients who had previously undergone a non-vascularized fibula strut and corticocancellous autograft procedure for gap nonunion of the lower limb. The mean gap was 5.9 cms, with 11 patients involving tibia gap nonunion and seven involving the femur. The mean age of the patients was 37.9 years, with a mean follow-up of 1.78 years. The patients underwent surgeries for femur nailing (static mode) and locking plates by standard technique using a standard lateral approach to the femur and tibia, respectively.

Results

The mean number of surgeries that each patient underwent was 3.17, with patients showing union at a mean of 15.8 weeks. Shortening was a common but acceptable complication, with the mean being 1.39 cms, along with three cases of failure.

Conclusion

The age-old method of non-vascularized fibula with autogenous corticocancellous bone grafting is a good method for treating nonunion, but patient selection as well as good bone grafting, rigid stability with an absence of infection, and good surrounding soft tissue vitality is mandatory for achieving success.

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Correspondence to A. C. Pathak.

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Nataraj, B., Singh, V., Pathak, A.C. et al. Non-vascularized fibula and corticocancellous bone grafting for gap nonunion of lower limb—retrospective study of 18 cases—an age old technique revisited. Eur Orthop Traumatol 5, 277–283 (2014). https://doi.org/10.1007/s12570-014-0254-2

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