Abstract
Introduction: Complex wounds of the extremities have always been a challenge for the reconstructive surgeon. Non-vascularized methods for the reconstruction of bony defects are associated with more complications. So the free vascularised fibular flap (FVFF) has become a workhorse flap for the reconstruction of these defects. In this study we aim to share our experience of reconstruction of such defects using free vascularised fibular flap.
Material and methods: We performed a retrospective study of the 18 patients who underwent extremity reconstruction with free vascularised fibular flap at our hospital i.e. Yenepoya Medical College and Hospital, Mangaluru during a five-year period i.e. from January 2019 to December 2023. In all these patients, we studied and evaluated the cause and location of defects, type of free vascularised fibular flap, choice of the recipient vessels, type of the anastomosis, the survival rate, functional outcomes and complications.
Results: Totally 18 patients with a mean age of 39.4 years had undergone extremity reconstruction with a free vascularised fibular flap with complete bone viability. The defects were present within the humerus, radius, femur, tibia and metatarsal. Union at the osteotomy sites was noted radiologically at an average time of five months. The average period to return function was 14 months.
Conclusions: The use of a free vascularised fibula flap is the best modality for the reconstruction of the bony defects of the limb and is proved to have a high bony healing rate, early return to ambulation, good function of the extremity and less incidence of complication regardless of the cause of the bony defect. One or more skin paddle can be taken along with the bone for the coverage in case of exposure of deeper tissue.