The free vascularised fibular transfer as a definitive treatment in femoral septic non‐unions

Abstract

Free vascularised bone transfer (fibula, iliac crest, or rib) is an accepted method of bone grafting in malignant and non-union bone surgery. The vascular microanastomoses have transformed the bone healing by creeping substitution seen after non-vascularised grafting (a long and often insufficient process) into normal healing of the fracture site. The presence of its own vascular support allows bone healing in such compromised circumstances as sclerosis and infection. We present the clinical history of five patients with septic femoral non-unions, in which only the final vascular fibular graft provided an acceptable outcome. Discussion about the indication and timing of this microsurgical salvage procedure is still controversial.