Free non-vascularised fibular graft for treatment of post-traumatic bone defects.

Post-traumatic bone defects usually occur from severe high-velocity injuries due to road traffic accidents; they may be difficult to fill. We have managed defects of long bones by the use of free non-vascularised fibular grafts harvested subperiosteally and held by screw fixation of the fibular strut ends to the ends of the bone defect, combined with an external fixator in 8 tibial defects and with a plate and screws in 2 ulnae and 2 humeri. Twelve patients, eleven male and one female, with a mean average age of 25 years (range 12-40), underwent this procedure. Eleven grafts (92%) united at both ends within an average of 4 months (range, 3 to 5 months). The defect lengths averaged 7 cm (range from 6 to 10 cm). The long-term follow-up showed complete 'tibialisation' of the fibula. Non-vascularised fibular graft, compared to microvascular reconstruction and Ilizarov techniques, is a simple procedure that is still valid to bridge bone defects successfully in selected cases.