Tibialization of the fibula in a child with chronic osteomyelitis of the tibia: a case report

Abstract

A case of a ten year old patient on treatment for chronic osteomyelitis of the right tibia is presented. After undergoing multiple sessions of debridement and sequestrectomy, first at a district hospital then at Kenyatta National Hospital, the patient ended up with a large bone defect of the tibia. After his infection was clinically cured, the options for surgical management of the tibial defect included: a through-knee disarticulation, segment transport with the help of a ring fixator and tibialization of the fibula. Amputation was deemed too radical a procedure in a young patient especially now that the infection was cured. Segment transport would have been difficult considering that the bone defect involved almost 70% of bone length. Additionally, we were doubtful how compliant the patient would have been with distraction of the callus by fixator once discharged. We therefore employed tibialization of the fibula to treat this patient. This case discusses tibialization of the fibula as a viable option for management of large bone defects of the tibia.