Inter-tibiofibular graft for traumatic segmental bone defect of the tibia - 29/02/12

Doi : 10.1016/j.otsr.2012.01.002

F. Fitoussi ^a,^⁎ , A.-C. Masquelet ^b, S. Rigal ^c, A. Poichotte ^d, T. Bauer ^e, A. Fabre ^f
the French Society of Orthopedic and Traumatologic Surgery (SoFCOT)56, rue Boissonade, 75014 Paris, France
^a Pediatric Orthopedic Surgery Dept, Robert-Debré Hospital, 48, boulevard Serurier, 75019 Paris, France
^b Orthopedic Surgery Dept, Avicenne Hospital, AP–HP, 123, route de Stalingrad, 93009 Bobigny, France
^c Orthopedic Surgery Dept, Percy Military Teaching Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France
^d Orthopedic Surgery Dept, Loire-Vendée Hospital Center, boulevard Guérin, 85302 Challans, France
^e Orthopedic Surgery Dept, Ambroise-Paré Hospital, AP–HP, 9, avenue Charles-de-Gaulle, 92110 Boulogne-Billancourt, France
^f 106, rue de Général-Sarrail, 17100 Saintes, France

Corresponding author.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 29 February 2012
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Summary

Introduction

The present study sought to assess the interest of inter-tibiofibular graft (ITFG), alternatively called posterolateral bone graft, in traumatic segmental tibial bone defect.

Material and methods

Twenty-eight ITFGs were performed in 125 tibial reconstructions for traumatic bone defect. Patient’s records were reviewed retrospectively in a multicenter study. Tibial reconstruction with and without ITFG was compared for bone healing and patient’s return to full weight-bearing status.

Results

There were no failures of bone healing in the ITFG group, versus 14 (14%) in the non-ITFG group. Graft-to-consolidation delays were shorter with first-line ITFG, at a mean 10 months (range, 3–20 months) versus 16.5 months (range, 3–63 months) in the non-ITFG group (P<0.05). Weight-bearing was likewise more quickly resumed, with full weight-bearing at a mean 9 months (range, 3–19 months) versus 15 months (range, 1–34 moths) respectively (P<0.05). Return to work was also quicker, at a mean 15 months (range, 4–28 months) versus 27 months (range, 8–56 months) respectively (P<0.05).

Discussion

This study confirmed the interest of ITFG in tibial bone defect reconstruction. ITFG may singly be used for small defects less than 4cm, or in conjunction with another tibial reconstruction technique; ITFG in the present series achieved consolidation in all cases and significantly shortened the times to return to full weight-bearing status and to work.