Fibular Resection

A fibular resection is a procedure that involves removing a tumor, usually malignant or benign aggressive, of the fibula. The fibula is the bone that is next to your shin bone. This is done while preserving the surrounding bone and soft tissues.

Fibula Xr

What is a Fibular Resection?

The compartment of the knee involves the tibia, fibula, patella, and distal femur bones. The fibula is a relatively small bone in comparison to the tibia (shin bone) and is a rare anatomic location for both primary and metastatic bone tumors. When a lesion does arise in this area, it typically occurs in the proximal fibula (part of bone closest to knee), followed by the diaphysis (middle part of bone), and finally the distal fibula (lower part of bone near ankle). The most common tumors to arise from the fibula, include chondrosarcoma, osteosarcoma, and benign aggressive cysts. Limb-sparing surgery can be performed for approximately 95% of tumors arising from the fibula. In some instances the extremity cannot be saved and an above the knee amputation is performed. 

Contraindications for saving the limb may include neurovascular invasion, infection, pathological fracture, extensive disease, involvement of the tumor into adjacent bone (tibia), contamination from a poorly performed biopsy, recurrent disease. 

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What’s involved in the technique?

What you can expect afterwards

After your surgery you may spend a few nights in the hospital. Once discharged from the hospital, you will be recuperating at home. Various pain protocols and nerve blocks are used to minimize pain. Mostly all patients are very comfortable after the surgery. For the first few days you will ice the area and keep it elevated to reduce swelling. You will return to the office 2 weeks after surgery. Once cleared, you may subsequently start physical therapy depending on the extent of your procedure. We usually prescribe specific physical therapy protocols 3 times a week for 12 weeks after surgery to gradually strengthen muscles. Strengthening with significant resistance after sufficient range of motion is achieved as determined by Dr. Wittig. There may be an ultimate weight limit imposed upon you depending on various factors.  

You will be monitored periodically with X-Ray and MRI imaging over the course of 5 years to ensure there are no signs of recurrence. You will have follow up appointments every 4 months for the first 2 years, then every 6 months for the next 2 years, and then once a year. Since the integrity of the limb has been restored to full or almost full, recovery is anticipated provided the patient adheres to strict physical therapy.

Types Of Physical Therapy

Fibular Resection Video

Dr. James Wittig narrates a video illustrating the surgical technique for resection of the fibula. | WATCH VIDEO