Vascularised fibular graft using reverse peroneal flow in the treatment of congenital pseudarthrosis of the tibia.

Pseudarthrosis of the tibia represents one of the more difficult conditions to treat, often resulting in delayed amputation or shortening. A technique is described where the central segment of the fibula containing the nutrient artery can be mobilised based on retrograde peroneal artery flow. This can then be transposed and slotted into the tibial defect after resection of the pseudarthrosis, allowing bone replacement and correction of length. In the initial two cases presented the bone behaved in the same way as a successful microvascular transfer.