Abstract

 

Nonunion of tibia! fractures is a challenging problem that often necessitates the use of bone grafts. Cancellous, orticocancellous, vascularized, and nonvascularized pedicled and free grafts and flaps have been described. Cadaveric allografts have made it possible to bridge bony defects and to salvage extremities in patients in whom tumors have been resected, but the fracture rate is high (15 to 45 percent), and the graft is prone to nonunion because of antigenicity, resorption, and impaired healing. Allograft exchange, fracture reduction and closed fixation, amputation, and vascularized bone grafts have been also used for the treatment of allograft fracturesIn this report, we describe the successful use of an interpositional vascularized fibular graft for the treatment of tibial fracture nonunion after a failed allograft in a patient with a history ofosteosarcoma ofthe left tibia.

Key words: fibular flap / graft, allograft nonunion and fracture.