Year: 2024 | Month: April | Volume: 14 | Issue: 4 | Pages: 197-201
DOI: https://doi.org/10.52403/ijhsr.20240429
Vascularized Fibular Graft for Non-Union of Tibial Long Bone with Acute Exacerbation Osteomyelitis in Pediatric Patient: A Case Report
Agus Suarjaya Putra1, Made Bramantya Karna2, AA Gde Yuda Asmara2
1Resident of Orthoapedic & Traumatology, RSUP. Prof. I.G.N.G Ngoerah, Faculty of Medicine, University Udayana, Denpasar, Bali, Indonesia
2Consultant of Orthopaedic & Traumatology, RSUP. Prof. I.G.N.G Ngoerah, Faculty of Medicine, University Udayana, Denpasar, Bali, Indonesia
Corresponding Author: Agus Suarjaya Putra
ABSTRACT
Introduction: Osteomyelitis has more consolidated data in the medical literature, and is considered a predominantly pediatric disease, with 85% of patients aged below 17 years. Debridement is necessary for treatment, sometimes causes a bone defect. Vascularized bone grafts, like the vascularized fibular graft as surgical management for long bone osteomyelitis, that may maintain their intrinsic blood supply, speed up bone healing, and promote bone hypertrophy. This case report aims to evaluate about osteomyelitis on the right tibial bone with treated by vascularized fibular graft.
Case of presentation: A 4 years old female Balinese complained of swelling in the right leg from 8 months ago. The physical examination of right leg region revealed swelling over middle part of leg, scar post-operative and redness over middle part and tenderness around swollen soft tissue. On laboratories examination revealed an elevated CRP (26) and an elevated WBC (15,420). Meanwhile, On X-ray examination revealed suggestive osteomyelitis on the right tibial bone. We decided to performed surgical approach by using vascularized fibular graft to tibial bone infected. The patient was not complaint after surgery, and she undergo to follow rehabilitation protocol.
Discussion: VFF seems to be a valuable reconstructive technique for the treatment of osteomyelitis in tibial bone. The indication for VFF is skeletal defect greater than 6 cm in length. Fibular osteocutaneous is the most commonly used as vascularized bone graft clinically.
Conclusion: In conclusion, this case describes a rare presentation of spontaneous osteomyelitis of the tibial bone. A vascularised bony reconstruction with a VFF graft was performed. There was no complications following surgery in this patient.
Key words: Osteomyelitis, vascularized fibular graft, tibial bone, long bone, graft.