Femoral diaphyseal reconstruction using free non-vascularised fibular graft in a paediatric case of postinfective gap non-union

Free non-vascularised fibular grafts are an autologous grafting option that requires a simple technique and minimal expertise to replicate. However, due to limited intrinsic biological activity, they are less preferred than their vascularised counterparts for reconstructing large bone defects. We present a case of a female child in her middle childhood with limb length discrepancy due to extensive femoral diaphyseal bone loss following successful treatment of chronic osteomyelitis of the femur. In this case, successful reconstruction of the femoral diaphysis was achieved using a free non-vascularised fibular graft, resulting in a good range of motion around the knee with no graft donor site morbidity at the latest follow-up. Therefore, we conclude that with adequate soft tissue coverage and vascularity for large bone defects, even a free, non-vascularised fibular graft can yield promising results with complete union and hypertrophy at the graft host junction.