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PubMed1992

[Role of tibial-fibular grafting in the treatment of infected pseudarthrosis of the tibia].

The author presents a series of 112 patients, suffering an infected fracture or nonunion of the tibia, and operated on by intertibio-fibular grafting (ITFG), between 1960 to 1990. 110 of them were followed up during average 5 years. Some points of the technic are detailed. The whole treatment associates immobilization, antibiotherapy, cleaning procedures and eventually complementary grafting. All patients were consolidated, 73 after ITFG alone, 13 by association, in the same stage, of an open cancellous filling, following Papineau technique. 24 needed a complementary grafting, among them 7 because a technical flaw. 5 iterative fractures were observed, only one of them has not united. 96 patients were cured of any sepsis, most often by associated cleaning procedures, achieved either before or after ITFG. It existed 14 persistent draining sinus, but only 4 may be considered as real failures. The involvement of the ankle joint was unfortunately quite frequent, but it did not seem to be the consequence of the synostosis, but rather of the duration of immobilization. After review of the literature, the other methods of treatment were discussed, particularly these of Papineau and of Ilizarov. The conclusion was that each method has indications, but the ITFG must keep the largest place, being indicated in about two cases out of three.

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