A simple method of two-stage transplantation of the fibula into the tibia has been used in nine cases of complicated pseudarthrosis. These included four adults of whom three had infected pseudarthrosis, and one uninfected, but with pseudarthrosis still present following two previous bone-grafting operations; and five children with congenital pseudarthrosis or pseudarthrosis resulting from operative correction of congenital bowing, in four of whom previous bone-grafting operations had been done with failure. Bony union of the pseudarthrosis developed spontaneously in six of these nine cases, and in the others supplementary bone-grafting operations resulted in success.
Fibular transplantation has a much wider application in the treatment of tibial pseudarthrosis than has been previously realized, and should not be reserved for those cases in which there are gross tibial defects. The method is worth consideration in cases of infected or complicated pseudarthrosis, and also in the congenital pseudarthrosis of childhood.