Vascularized fibula transfer for lower limb reconstruction.

Area of Science:

• Orthopedic Surgery
• Microsurgery
• Regenerative Medicine

Background:

• Massive lower extremity bone defects often result from high-energy trauma, tumor resection, or severe sepsis.
• Reconstruction is challenging, particularly in compromised recipient sites or combined bone/soft-tissue defects.

Purpose of the Study:

• To review the surgical techniques, indications, outcomes, and complications of free vascularized fibular grafts for lower limb reconstruction.
• To highlight the versatility and effectiveness of this autograft in managing large skeletal defects.

Main Methods:

• Literature review of studies on free vascularized fibular graft (FVFG) applications.
• Analysis of surgical techniques, including fibula folding and composite flaps.
• Evaluation of factors influencing outcomes and complication rates.

Main Results:

• FVFG is a preferred autograft for middle tibia reconstruction due to its shape, strength, and vascularity.
• Techniques like fibula folding and composite transfer enable reconstruction of femur and proximal tibia defects.
• Proximal epiphyseal transfer allows for longitudinal growth, aiding hip joint remodeling.

Conclusions:

• Free vascularized fibular grafting is a versatile and effective method for reconstructing massive lower limb bone and composite defects.
• Meticulous planning, microsurgical technique, and postoperative care are crucial for minimizing complications and optimizing results.