{
  "abstract": "Background: Infected non-union of the lower limb is among the most challenging conditions in orthopedic surgery. Vascularized fibular grafting (VFG) is a limb-salvage option for large infected bone defects, but outcomes accounting for competing events remain poorly documented. Methods: We conducted a retrospective single-center study of adults treated consecutively with VFG for infected femoral or tibial non-union between 2014 and 2023. Infected non-union combined institutional non-union criteria with fracture-related infection as per international consensus definitions. Treatment success was defined as consolidation with infection remission. Amputation and death were competing events; cumulative incidence of consolidation was estimated using competing-risk methods. Results: A total of 22 patients were included (median age of 45 years). Consolidation was achieved in 17 patients (77 %), infection remission was achieved in 16 (73 %), and treatment success was achieved in 16 (73 %): 9 (41 %) after VFG alone and 7 (32 %) after secondary bone grafting. Six patients (27 %) had unfavorable outcomes: four amputations, one persistent non-union, and one death. The median time to consolidation was 14 months after VFG alone and 38 months after secondary grafting. Cumulative incidence of consolidation reached approximately 18 % at 12 months, 41 % at 24 months, 59 % at 36 months, and 76 % by end of follow-up. All seven patients undergoing secondary grafting for delayed consolidation ultimately achieved union; no formal comparative analysis was performed given the small, time-dependent sample. Conclusion: VFG is a valuable limb-salvage strategy for selected patients with infected non-union. Consolidation may occur late, underscoring the need for prolonged follow-up and competing-risk methodology. Findings should be interpreted given the retrospective design, small sample, and heterogeneous follow-up.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "name": "Anne Le Hir"
    },
    {
      "name": "Piseth Seng"
    },
    {
      "name": "David Delarbre"
    },
    {
      "name": "Romain Ambrosino"
    },
    {
      "name": "Najib Kachouh"
    },
    {
      "name": "Régis Legré"
    },
    {
      "name": "Andreas Stein"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8y9haebsjtz8y.bib",
  "cited_by": 0,
  "doi": "10.5194/jbji-11-579-2026",
  "fulltext_url": null,
  "id": "8y9haebsjtz8y",
  "issns": [
    "2206-3552"
  ],
  "landing_url": "https://amu.hal.science/hal-05836687v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
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      "hal",
      "1.sdv.mhep"
    ],
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      "1.sdv.mp"
    ],
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      "hal",
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      "openalex",
      "2713|Bone fractures and treatments"
    ]
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  "openalex": "W7213330774",
  "pdf_url": "https://amu.hal.science/hal-05836687/document",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-15",
  "publisher": "Copernicus Publications",
  "ris": "https://research.draconitic.com/paper/8y9haebsjtz8y.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:01Z",
      "native_id": "hal-05836687",
      "source": "hal",
      "url": "https://amu.hal.science/hal-05836687v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:1.sdv.mp",
      "subfield": "microbiology"
    },
    {
      "field": "medicine",
      "origin": "hal:2.sdv.mhep.csc",
      "subfield": "cardiovascular"
    },
    {
      "field": "medicine",
      "origin": "hal:2.sdv.mhep.me",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Long-term outcomes of vascularized fibular grafting for infected non-union of the lower limb: a competing-risk analysis",
  "title_text": "Long-term outcomes of vascularized fibular grafting for infected non-union of the lower limb: a competing-risk analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:01Z",
  "url": "https://research.draconitic.com/paper/8y9haebsjtz8y",
  "venue": "Journal of Bone and Joint Infection",
  "versions": []
}