Osteocartilaginous Transfer of the Proximal Part of the Fibula for Osseous Overgrowth in Children with Congenital or Acquired Tibial Amputation by Graham

Osteocartilaginous Transfer of the Proximal Part of the Fibula for Osseous Overgrowth in Children with Congenital

or Acquired Tibial Amputation

by Graham T. Fedorak, Hugh G. Watts, Anna V. Cuomo, Julian P. Ballesteros, Heather J. Grant, Richard E. Bowen, and Anthony A. Scaduto

J Bone Joint Surg AmVolume 97(7):574-581

April 1, 2015

©2015 by The Journal of Bone and Joint Surgery, Inc.

Preoperative clinical appearance of terminal overgrowth.

Graham T. Fedorak et al. J Bone Joint Surg Am 2015;97:574-581


Representative preoperative radiograph.



Resection of the tapered tibia and fibula.



Elevated periosteal flaps.



Fibular harvest can be done via one incision or two, depending on the length of the residual limb.



Insertion of the osteocartilaginous fibular graft into the tibia.



The metaphyseal flare of the fibula ensures a tight fit.



Postoperative radiograph.



Kaplan-Meier survival curve for the proportion of patients without revision for overgrowth.



Kaplan-Meier survival curve for the proportion of patients without repeat surgery for any reason.



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Osteocartilaginous Transfer of the Proximal Part of the Fibula for Osseous Overgrowth in Children with Congenital or Acquired Tibial Amputation by Graham