Successful reconstruction of a post-traumatic defect of 16 cm of the distal femur by modified Capanna's technique (vascularised free fibula combined with allograft) - A case report and technical note.
Rajasekaran RB., Jayaramaraju D., Venkataramani H., Agraharam D., Shanmuganathan RS., Shanmuganathan R.
Reconstruction of large defects following trauma in the distal femur are a surgical challenge. These cases usually require multiple procedures and are associated with poor functional outcomes. We managed a post-traumatic distal femur defect of 16 cm using the modified Capanna's technique - combination of a vascularised free fibula and an allograft - and achieved a successful union at 6 months and also a good functional outcome with knee flexion of 100°. The patient received a vascularised free fibula which was pegged into an allograft which was sculptured to bridge the defect. The construct was fixed with a locking compression plate on the lateral side. With the allograft providing structural stability and the vascularised free fibula enhancing biology, our technique which involves the expertise of an orthopaedic surgeon and a plastic surgeon is a useful single stage procedure to manage large post-traumatic bone defects.