Severe compartment syndrome following fibula harvesting for mandible reconstruction

There are many reports of the use of free fibular flap for mandible reconstruction, but donor site morbidity is not uncommon. The authors present the case of a 52-year-old man who underwent mandible reconstruction with free fibular flap. After surgery, he developed severe compartment syndrome involving all four-calf compartments. Debridement of the necrotic areas was followed by posterior nerve neurolysis and soft tissue coverage with free latissimus dorsi and anterior serratus muscle flaps. The postoperative period was uneventful and the patient remained with diminished plantar sensation 1 year later. Compartment syndrome after fibula harvesting is a possibility and should be recognized as soon as possible in order to limit extensive damage to the calf muscles and nerves.