[Donor site morbidity after free fibula flap. Report of 42 consecutive cases]

Donor site morbidity after free fibula flap was assessed in 42 patients, 37 of whom had undergone mandibular reconstruction and five proximal humerus. Lower limb reconstructions were excluded. The study comprised functional assessment with two international orthopaedic scales (Karlsson and Kitaoka); comparative lower limb clinical and X-ray assessment. Mean Karlsson score was 90.4/100 with 52% of excellent, 36% of good, and 12% of medium results. Mean Kitaoka score was 93.7/100 with 64% of excellent, and 36% of good results. Fifty-two percent of patients were pain free, 29% had pain on walking on uneven terrain, and 19% occasionally; 7% experienced instability. For 76%, physical activity was unrestricted. Clinical examination found no alteration in hindfoot axis, no joint laxity, mild and acceptable reduction in hallux plantar flexion power in 76% cases, and superficial fibular nerve hypoesthesia in 5% of cases. Methodology and results are detailed and compared to the literature. In conclusion, we found only slight morbidity and free fibula flap remains our first choice as bone flap.