The Use of Free Fibula Flap in Different Extremities and Our Clinical Results

Background and objectives Plastic, orthopedic, otolaryngology, and oromaxillofacial surgery specialists rely on fibula grafts to solve reconstructive problems. The aim of this study is to discuss the use and results of vascular fibula flaps in the treatment of bone and soft tissue defects in various regions with different etiologies. Materials and methods In our clinic, we treated 32 patients with osteocutaneous fibular flaps due to bone and soft tissue defects of different etiologies and varying anatomical regions. In our study, age, gender, side, cause of injury, surgical technique, treatment results, and complications were evaluated for each patient. Results Of the 32 patients, 25 were male, and 7 were female. The average age is 37.2 (27-56). The mean bone defect size was 10.45 cm. Bone defect occurred in eight patients due to osteomyelitis, eleven patients due to gunshot wounds, nine patients due to pseudoarthrosis, and four patients due to a giant cell tumor. We applied osteocutaneous fibula flap in 27 patients and vascularized fibular flap in five patients. Bone union could not be achieved in four patients, and bone grafting was performed as a secondary surgery. Local infection occurred in five patients, and their treatment was completed with debridement and antibiotic administration. Wound complications occurred in three patients at the donor site, which were treated with debridement and skin grafting. The mean duration of radiological union was three months, and complete union was achieved in the seventh month. Conclusions We have shown in our case series that free vascularized fibula transfer has gained an important place in the field of skeletal reconstruction and is a reliable method for various bone reconstructions.