Proximal tibial reconstruction with auto transplantation of the fibular growth plate: two case reports, describing the surgical technique

• Published in: SpringerPlus Vol. 5; no. 1; p. 490
• Main Authors: Baptista, Pedro Péricles Ribeiro, Bannwart, Cassiano Leão, Batista, Felipe Augusto Ribeiro, Bellan, Davi Gabriel
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 20.04.2016; Springer Nature B.V
• Subjects: Case Study; Humanities and Social Sciences; Medicine; multidisciplinary; Science; Science (multidisciplinary); Fibula; Fixation; Tibialization; Sarcoma; Growth; Device; Sliding; Physis; Transplant
• ISSN: 2193-1801; 2193-1801
• DOI: 10.1186/s40064-016-2042-7

Introduction Tumors of the proximal tibia, in children, can affect the growth plate and pose a challenge to further reconstruction of the bone defects resulting from tumor resection. Reconstruction methods do not always compensate the potential for bone growth in this segment. We present a new surgical technique of bone reconstruction, based on the transposition of the ipsilateral fibula with its growth plate and the use of an internal sliding fixation device, without need for microsurgical technique. Case description We report two patients with osteosarcoma of the proximal tibia affecting the growth cartilage who were treated with the new technique. Discussion and Evaluation In both cases, bone healing, hypertrophy and longitudinal growth of the transposed fibula were documented. Conclusions This new technique preserves the blood supply of the auto-transplanted bone segment, maintaining physeal growth potential, with no need for microsurgery. The implant allows longitudinal bone growth, which was radiographically confirmed. Level of evidence Case report, Level IV.