Tibialization of fibula in critical bone defect due to post traumatic osteomyelitis of the tibial shaft: A case report

Introduction and importance: Post-traumatic osteomyelitis in patients with an open fracture is one of the most common causes of a bone defect after an extensive debridement and one of the most challenging complications to treat. Removal of devitalized and infected tissue may result in a large defect that requires subsequent reconstruction. Case presentation: Two patients that underwent tibialization were included in this study. The first patient is a 32-year-old male with an infected non-union of the left shaft tibia and the second patient is a 10-year-old boy with a gap non-union of the right shaft tibia due to open fracture with bone loss. Both patients resulted in proximal and distal bone union and full weight bearing on the affected leg without limitation and pain. Nine months Follow up for the first patient show the proximal and distal bone union and an addition to the width of the fibular graft in X-ray examination showing promising results. For the second patient, follow-up 12 months after surgery shows a complete union of the proximal and distal bone union. Clinical discussion: Debridement would lead to soft tissue loss, which usually results in large injury defects. Tibialization of the fibula, also known as fibula pro tibia grafting, is one of the known reconstruction methods in treating patients with segmental defects in the tibia. Conclusion: Critical bone defects remain one of the most challenging orthopaedic conditions to treat. Tibialization is an excellent option with an acceptable functional outcome to treat critical bone defects.