I am 46-year old woman who broke my tibia and fibula in a fall on January 9, 2003. The tibia has not healed and I need another surgery to put it back into a straight line and to assist it to heal.

The problem is that I am getting conflicting medical opinions about what surgery to have next. One surgeon (at Mayo Clinic in Rochester, Minn.) wants to take a bone graft from the iliac crest in order to try to promote bone growth. This will require continuing to be non-weight bearing for at least three more months. Two different surgeons I have consulted locally want to insert a rod and then graft over the rod if needed. They also advise re-breaking the fibula in order to get the length of it to match the tibia, which has lost some bone.

The idea of the rod insertion, which would result in weight-bearing walking in about 4 weeks, is so appealing that I am afraid that it is hard to consider the graft alone. Has anyone faced a similar decision? Or has anyone gotten the bone graft without a rod insertion? Any pros or cons on either procedure?

Thank you!!!

-- Alice White (ABWhite@cfl.rr.com), July 06, 2003

Answers

It is hard to tell which has the highest chance of success without seeing the xrays. Rodding with bone grafting is certainly an accepted approach. If you have it done by an experienced surgeon and are more happy with the earlier weight-bearing, I would go with that.

-- Marc Hungerford, M.D. (mhunger@jhmi.edu), July 08, 2003.

I have a tibia non-union. My treatment has been to apply a Taylor Spatial Frame (next-generation Ilizarov device) to put the bone pieces in alignment; a graft with OP-1 may be necessary to fill the gap resultant from the movement of the bones, but we are hopeful that this will not be necessary - that enough bone will grow spontaneously. In my case a rod was not practical - there was insufficient are to affix it to.

-- Richard Litten (Staricius@aol.com), October 10, 2003.

My story actually starts 32 years ago. But jumping ahead 30 years, I have fractured my femur twice in the last two years, this 2nd fracture has just been diagnosed as a non-union (it has been 1 year). Recently discovered is a marked mal-alignment of my tibia from the original accident 30 years ago. I also have severe regional osteoporosis from the tibial mal-alignment area, extending up to mid- femur. I am desperately looking for any bone center that can tackle my situation. I live in Idaho but would go anywhere. Any suggestions?

-- Lill Gerich (lillger@hotmail.com), November 29, 2003.