THE FREE VASCULARIZED FIBULAR TRANSFER AS A DEFINITIVE TREATMENT IN FEMORAL SEPTIC NON-UNIONS

Free vascularised bone transfer (fibula, iliac crest, or rib) is an ac cepted method of bone grafting in malignant and nonunion bone surgery. The vascular microanastomoses have transformed the bone healing by cr eeping substitution seen after non-vascularised grafting (a long and o ften insufficient process) into normal healing of the fracture site. T he presence of its own vascular support allows bone healing in such co mpromised circumstances as sclerosis and infection. We present the cli nical history of five patients with septic femoral non-unions, in whic h only the final vascular fibular graft provided an acceptable outcome , Discussion about the indication and timing of this microsurgical sal vage procedure is still controversial. (C) 1995 Wiley-Liss, Inc.