Reconstruction of bone and soft tissue defects with free fibula transfer

More and more it is recognized that for the reconstruction of extensive long-bone defects, especially in combination with soft tissue loss, revascularized bone transfers are preferable. For the reconstruction of larger bony defects, revascularized crista iliaca bone or fibula bone are the first choice. The fibula has certain advantages over the crista: It is a straight cortical bone, the length is almost always sufficient to reconstruct large defects, and soft tissue reconstruction is possible by including a skin island. A short description of the operation technique, pitfalls, and indications are given.