TITLE:
Limb Length Restoration through Novel Limb Salvage Procedure on Medial Column via Ipsilateral Fibular Strut Autograft: Technique Guide
AUTHORS:
Carly Cook, Woo Young Chun, Bhumi Patel, Douglas Glod
KEYWORDS:
Fibula, Autograft, Strut, Medial Column, Reconstruction
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.16 No.1,
January
22,
2026
ABSTRACT: In this paper, we describe a novel medial column reconstruction using an ipsilateral fibular strut autograft in a patient with Charcot-related midfoot collapse following excision of nonviable medial cuneiform bone. The harvested fibula was segmented into three struts and reconstituted into a single column using a railroaded Kirschner wire configuration, preserving a central canal for intramedullary screw fixation. This construct was incorporated into medial column arthrodesis with adjunctive hindfoot arthrodesis and ankle syndesmotic stabilization. In our case, we discovered ipsilateral fibular strut autografting provides a biologically favorable and mechanically stable option for medial column length restoration in complex limb salvage cases. This technique offers osteogenic potential, enhanced structural support, and precise restoration of medial column length, and may serve as a reliable alternative to allograft in select patients.