Clawtoe deformity following vascularized fibula graft

Area of Science:

• Orthopaedic Surgery
• Microsurgery
• Reconstructive Surgery

Background:

• Free vascularized fibula grafts are widely used in orthopaedic surgery due to their versatility and low donor site morbidity.
• This technique involves harvesting the fibula bone along with its vascular supply for reconstructive purposes.
• Potential complications are generally minimal, contributing to its popularity.

Observation:

• The study presents two distinct cases of patients who developed multiple ipsilateral clawtoe deformities.
• These deformities were observed following the ipsilateral harvest of a free vascularized fibula graft.
• This specific complication has not been previously documented in existing medical literature.

Findings:

• The primary finding is the occurrence of multiple ipsilateral clawtoe deformity as a potential complication of free vascularized fibula graft harvest.
• While isolated flexor hallucis longus contracture is known, this presentation involves a more complex, multi-toe deformity on the same side as the graft harvest.
• These findings highlight a novel iatrogenic effect associated with this surgical procedure.

Implications:

• The findings suggest that surgeons should be aware of the potential for developing multiple ipsilateral clawtoe deformities after fibula graft harvest.
• Further investigation may be warranted to understand the underlying mechanisms and risk factors associated with this complication.
• This information could inform surgical technique modifications or patient counseling regarding potential, albeit rare, post-operative foot deformities.