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Am J Otolaryngol 2020 May 12:102536. Epub 2020 May 12.

Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America. Electronic address:

Learning Objectives: Identify factors associated with skin graft take in fibula free flaps (FFF) and radial forearm free flaps (RFFF) donor sites.

Study Objectives: To determine which factors are associated with decreased skin graft take at the donor site in FFF and RFFF in head and neck patients.

Design: Retrospective Chart Review Case Series. Read More

Laryngoscope 2020 May 15. Epub 2020 May 15.

Mayo Clinic, Department of Otolaryngology - Head and Neck Surgery, Rochester, Minnesota, U.S.A.

Objectives: To describe pain experience and opioid use after major head and neck reconstructive surgery.

Study Design: Retrospective cohort study.

Methods: Patients undergoing major head and neck surgery with microvascular free tissue transfer (free flaps) at a tertiary academic center were included. Read More

Semin Plast Surg 2020 May 6;34(2):86-91. Epub 2020 May 6.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York.

Palatomaxillary reconstruction presents a unique challenge for the reconstructive surgeon. The maxillofacial skeleton preserves critical aerodigestive functions-it provides a stable hard palate to support mastication and separate the nasal and oral cavities, and buttress support to provide adequate midface contour. Free tissue transfer has become a routine part of the reconstructive ladder in managing palatomaxillary defects. Read More

Clin Case Rep 2020 Apr 20;8(4):612-616. Epub 2020 Feb 20.

Christine M. Kleinert Institute for Hand and Microsurgery Louisville KY USA.

We present two rare microsurgical reconstructions. A case with phocomelia was treated with lengthening of soft tissues following vascularized fibula grafting with epiphysis, and a case with cleft hand was reconstructed with spare-part toe transfer. Read More

Otolaryngol Head Neck Surg 2020 May 24;162(5):641-648. Epub 2020 Mar 24.

Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.

Objective: To determine the frequency at which patients with osteocutaneous free flap reconstruction of the head and neck develop long-term complications and identify predisposing perioperative factors.

Study Design: A prospectively maintained database of free flaps performed at a single institution over a 10-year period was queried.

Setting: Single tertiary care referral center. Read More

Am J Otolaryngol 2020 Feb 19:102436. Epub 2020 Feb 19.

Division of Facial Plastic and Reconstructive Surgery, Boston Medical Center, Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA. Electronic address:

Objective: Fibula free tissue transfer is a common and reliable method for mandibular reconstruction. Functional outcomes from this procedure are dependent on the successful union of the osseous segments postoperatively. This study was conducted to define the maximum gap-size criteria for osseous union to occur at osteotomy sites in fibula free flap reconstruction of the mandible. Read More

Am J Otolaryngol 2020 Jan 17:102404. Epub 2020 Jan 17.

Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America. Electronic address:

Purpose: Our objective was to understand which variables are associated with hematoma formation at both the donor and recipient sites in head and neck free tissue transfer and if hematoma rates are affected by tourniquet use.

Methods: Patients were identified who underwent free tissue transfer at three institutions, specifically either a radial forearm free flap (RFFF) or a fibula free flap (FFF), between 2007 and 2017. Variables including use of tourniquet, anticoagulation, treatment factors, demographics, and post-operative factors were examined to see if they influenced hematoma formation at either the free tissue donor or recipient site. Read More

Am J Otolaryngol 2020 Mar - Apr;41(2):102374. Epub 2019 Dec 10.

Cleveland Clinic, Head and Neck Institute, Cleveland, OH, USA.

Introduction: Demonstrate that carefully selected free flap patients may be discharged early after surgery without increasing the rates of postoperative complications or readmissions.

Methods: Based on a published article in Laryngoscope 2016 of 51 free-tissue transfers, a retrospective chart review was performed on an expanded cohort who underwent free-tissue transfer for head and neck reconstruction between February 2010 and May 2018 and discharged by postoperative day 3.

Results: 101 patients who underwent 104 free flaps with average age of 56 (3-84) years old were reviewed. Read More

J Clin Orthop Trauma 2019 Oct 14;10(Suppl 1):S231-S233. Epub 2018 Dec 14.

Department of Trauma and Emergency, AIIMS Bhubaneswar, Sijua, Patrapada, Odisha, 751019, India.

Defect in the lateral malleolus along with lateral ligamentous injury of ankle is rare. It occurs mainly due to resection of distal fibula tumors and severe trauma leading to loss of lateral malleolus. Lateral malleoli has the major contribution in weight transmission to foot and ankle stability. Read More

Laryngoscope 2020 Mar 30;130(3):679-684. Epub 2019 Jul 30.

Cleveland Clinic, Head and Neck Institute, Cleveland, Ohio, U.S.A.

Background: Predictive models to forecast the likelihood of specific outcomes after surgical intervention allow informed shared decision-making by surgeons and patients. Previous studies have suggested that existing general surgical risk calculators poorly forecast head and neck surgical outcomes. However, no large study has addressed this question while subdividing subjects by surgery performed. Read More

Laryngoscope 2020 Feb 9;130(2):347-353. Epub 2019 Jul 9.

Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.

Objective: Analyze the cause and significance of a shift in the timing of free flap failures in head and neck reconstruction.

Study Design: Retrospective multi-institutional review of prospectively collected databases at tertiary care centers.

Methods: Included consecutive patients undergoing free flap reconstructions of head and neck defects between 2007 and 2017. Read More

Laryngoscope 2020 Feb 4;130(2):343-346. Epub 2019 Jul 4.

Oregon Health Sciences University, Portland, Oregon.

Objective: The anterolateral thigh (ALT) free flap is a soft tissue flap used in head and neck reconstruction. Occasionally, its perforators to the skin paddle are absent or too small to support the flap. Salvage options in this scenario have not been well described for head and neck reconstruction. Read More

Hand (N Y) 2019 Jun 19:1558944719857168. Epub 2019 Jun 19.

1 Middlemore Hospital, Auckland, New Zealand.

Both bone forearm infective nonunions represent a rare but functionally limb threatening condition. We report a successful salvage of a severe near total both bone diaphysial osteomyelitis by conversion to a one-bone forearm with free fibula flap. A literature review on forearm salvage addressing both bone defects was performed. Read More

Oral Maxillofac Surg Clin North Am 2019 Aug 1;31(3):369-386. Epub 2019 Jun 1.

The Head and Neck Institute, Head and Neck Surgical Associates, 1849 Northwest Kearney Street, Suite 300, Portland, OR 97209, USA; Providence Cancer Institute, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 2N35, Portland, OR 97213, USA. Electronic address:

The fibula free flap is a workhorse flap used to reconstruct ablative, osseous defects in the upper and lower jaws. Traditionally, the fibula free flap is inset into the defect freehand; dental implants are placed secondarily; and final prosthetic rehabilitation often occurs more than 1 year after ablative surgery. Virtual surgical planning and rapid prototyping of cutting guides and guide stents for head and neck reconstruction have facilitated improved accuracy in fibular transfer. Read More

J Ayub Med Coll Abbottabad 2019 Apr-Jun;31(2):156-161

Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan.

Background: Free tissue transfer is a routine practice in adults with good success rates. Further advances in techniques and microsurgical skills have proved that free tissue transfer in paediatric population is feasible, reliable and safe.

Methods: This study is conducted to compare anastomosis duration, total general anaesthesia duration, hospital stay and outcomes of flaps (survival, partial loss, complete loss, complications) in paediatric group (age <15 years) and adult group (15-70 years age). Read More

Plast Reconstr Surg Glob Open 2018 Nov 21;6(11):e2034. Epub 2018 Nov 21.

Plastic and Reconstructive Surgery Section, Surgery Department, King Fahad Medical City, Riyadh, Saudi Arabia.

There have been very limited data on the use of pedicled peroneal artery perforator flaps in knee soft-tissue reconstruction, especially for anterior and medial defects. Here, we present a case of proximally based peroneal artery perforator flap for knee soft-tissue reconstruction in a defect that included lateral, anterior, and medial surfaces of the knee presenting the technical challenges associated with this flap. A 15-year-old girl presented with extruded knee implant after osteosarcoma resection of femur. Read More

Plast Reconstr Surg Glob Open 2018 Nov 28;6(11):e1913. Epub 2018 Nov 28.

Bethlehem Arab Society for Rehabilitation Hospital, Head of Plastic and Reconstructive Surgery Department Bethlehem, Palestine.

Constructing arteriovenous (AV) loops saves a crushed limb when healthy recipient vessels are unavailable at the site of injury by supporting a transferred free flap. Literature about using AV loops in the upper limb defect is scarce. We present a case with a devastating upper limb crush injury that was successfully managed with fibula flap transfer preceded by AV loop construction. Read More

Acta Orthop Belg 2018 Dec;84(4):384-396

Treatment of segmental bone defects resulting from trauma or infection is extremely difficult. Bone segment transport with distraction osteogenesis and vascularized fibula transfer are the commonest used methods of treatment. Bone transport has problems with docking site. Read More

Semin Plast Surg 2019 Feb 8;33(1):54-58. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

Reconstruction of bony and soft tissue defects of the lower extremity has been revolutionized by the advent of microsurgical tissue transfer. There are numerous options for reconstruction. Possibilities include transfer of soft tissue, composite (bone and soft tissue) tissue, and functional muscle. Read More

Semin Plast Surg 2019 Feb 8;33(1):17-23. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

With the advent of the Industrial Revolution, traumatic injuries of the upper extremity increased exponentially. As a result, surgeons began to reevaluate amputation as the standard of care. Following the Second World War, local and regional pedicled flaps became common forms of traumatic upper extremity reconstruction. Read More

Head Neck 2019 04 9;41(4):930-939. Epub 2019 Feb 9.

Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.

Background: Critical review of current head and neck reconstructive practices as related to free flap donor sites and their impact on clinical outcomes and cost.

Methods: Retrospective multicenter review of free tissue transfer reconstruction of head and neck defects (n = 1315). Variables reviewed: defect, indication, T classification, operative duration, and complications. Read More

J Craniomaxillofac Surg 2019 May 3;47(5):786-791. Epub 2019 Jan 3.

University Hospital Giessen, Dept. for Maxillofacial Surgery, (Head: Prof. Dr. Hans-Peter Howaldt), Klinikstr. 33, 35392, Giessen, Germany.

Purpose: Microvascular fibula flap surgery is a reliable and effective procedure for reconstructing the jaws after tumour surgery. This procedure allows the placement of dental implants after bone consolidation. This study was designed to evaluate the oral, functional, and aesthetic rehabilitation of tumour patients with immediate fibula transfer and dental implants and included assessment of diet, speech, and aesthetics. Read More

J Reconstr Microsurg 2019 Jul 31;35(6):438-444. Epub 2019 Jan 31.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.

Background:  Functional restoration in reconstructive surgery can require complex and adaptable approaches. In this anatomical study, the combined angiosome of the septofasciomyocutaneous vessels originating from the fibular artery was defined as basis for a chimeric flap of the lateral lower leg.

Methods:  Methylene blue injection into the fibular artery was performed in 10 legs of fresh cadavers for visualization of the angiosome on the skin, fibula, and adjacent muscles as the lateral hemisoleus (HS) muscle. Read More

Microsurgery 2019 May 15;39(4):290-296. Epub 2019 Jan 15.

Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Background: With the rising number of patients in advanced age receiving microsurgical procedures, coronary artery disease (CAD) and its challenging management is of increasing importance. Evidence based data concerning morbidity and mortality are rare. We present our experiences with this highly selected patient population and propose a preoperative assessment algorithm. Read More

Int Orthop 2019 11 15;43(11):2601-2605. Epub 2019 Jan 15.

Paley Orthopedic and Spine Institute, St. Mary's Hospital, West Palm Beach, FL, 33407, USA.

Purpose: Stump overgrowth is the main problem of limb amputation in children. Many surgical procedures have been developed to overcome the problem, but all have shown inconsistent results. The only surgical procedure that has been successful in preventing overgrowth is capping of the amputated limb with a cartilaginous cap taken from the amputated limb, usually from the head of fibula. Read More

J Oral Maxillofac Surg 2019 Mar 2;77(3):648-657. Epub 2018 Nov 2.

Professor, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy. Electronic address:

Purpose: The purpose was to evaluate donor-site clinical morbidity and changes in kinematic gait parameters after the harvest of a vascularized free fibula flap for facial reconstruction.

Materials And Methods: We enrolled 14 patients (aged 50 ± 15 years) in a longitudinal study. Every patient underwent a double evaluation in which a presurgical assessment and 6-month postsurgical assessment were performed. Read More

Br J Oral Maxillofac Surg 2018 11 4;56(9):859-863. Epub 2018 Oct 4.

Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.

The Surgical reconstruction of defects of the face is challenging. Local and regional flaps have an important part to play, but large defects of bone and soft tissue are a greater problem. Microvascular tissue transfer has become the standard for such patients, and preoperative planning of bony reconstructions is now common. Read More

Magy Onkol 2018 Sep 14;62(3):169-174. Epub 2018 Jun 14.

Fej-nyaki Daganatok Multidiszciplináris Központ, Országos Onkológiai Intézet, Budapest, Hungary.

Extended mandibular defects can be safely managed by applying microvascular free bone transfer. The flap of choice for this procedure is a fibula free flap due to its anatomical structure, proper length and good plasticity. The body of the mandible can be formed by removing wedge bone segments. Read More

Neurochirurgie 2018 Dec 19;64(6):434-438. Epub 2018 Sep 19.

Department of Neurosurgery, La Timone Hospital, 13005 Marseille, France. Electronic address:

The case under review is a 60-year-old patient with a vertebral plasmocytoma treated by cervico-thoracic fusion 2 years previously. He presented a thoracic spinal septic non-union complicated by esophagospinal fistula. We performed vascularized fibula transplant with cutaneous pad to fill the esophageal fistula. Read More

J Plast Reconstr Aesthet Surg 2018 Dec 24;71(12):1730-1739. Epub 2018 Aug 24.

Division of Orthopaedics and Traumatology, Unit of Musculoskeletal Surgery, Tampere University Hospital, Tampere, Finland; Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland.

Background: Sacrectomy is a rare and demanding surgical procedure that results in major soft tissue defects and spinopelvic discontinuity. No consensus is available on the optimal reconstruction algorithm. Therefore, the present study evaluated the results of sacrectomy reconstruction and its impact on patients' quality of life (QOL). Read More

J Pediatr Orthop B 2019 Mar;28(2):144-152

Pediatric Orthopaedic Unit, Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu, India.

We describe a technique for optimal use of fibula in reconstruction of type II tibial hemimelia. Six affected children with mean age of 1.4 years and treated over a 5-year period were reviewed. Read More

ANZ J Surg 2018 09 2;88(9):907-912. Epub 2018 Aug 2.

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.

Background: Mandibular and maxillary reconstruction using fibula free transfer is common in many tertiary referral centres. Virtual surgical planning (VSP) is a relatively recent adjunct that allows surgeons to plan resection and reconstruction prior to theatre. This has been shown to reduce operative times and decrease surgeon stress intraoperatively. Read More

NMR Biomed 2018 11 30;31(11):e3994. Epub 2018 Jul 30.

Department of Radiology, University of California, San Diego, California.

Bone stress injury (BSI) incidents have been increasing amongst athletes in recent years as a result of more intense sporting activities. Cortical bone in the tibia and fibula is one of the most common BSI sites. Nowadays, clinical magnetic resonance imaging (MRI) is the recommended technique for BSI diagnosis at an early stage. Read More

Otolaryngol Head Neck Surg 2019 01 24;160(1):100-106. Epub 2018 Jul 24.

1 Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Objective: This study evaluated the accuracy of the Surgical Risk Calculator (SRC) of the ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) in predicting head and neck microvascular reconstruction outcomes.

Study Design: Retrospective analysis.

Setting: Tertiary medical center. Read More

Am J Otolaryngol 2018 Sep - Oct;39(5):558-560. Epub 2018 Jun 18.

Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX, USA. Electronic address:

Introduction: In this study, we explore whether preoperative external beam radiation affects complication rates in patients that have undergone double simultaneous free tissue transfer for head and neck defects.

Study Design, Setting, Subjects And Methods: Approval was obtained from the JPS Institutional Review Board. We performed a retrospective analysis of patients who underwent double free flap reconstruction of head and neck defects between August 1997 and April 2017. Read More

J Craniomaxillofac Surg 2018 Aug 5;46(8):1205-1210. Epub 2018 Jun 5.

Private Practise MKG am Theater, Neuenweg16, 35390, Giessen, Germany.

Purpose: Ablative oncological surgery to treat head-and-neck cancer often triggers a requirement for jaw reconstruction. Modern surgical procedures using free microvascular flaps afford acceptable outcomes in terms of restoration of bony and soft tissue defects. A fibula free flap is often the preferred flap, as the bone length is considerable and a two-surgeon approach is possible. Read More

JAMA Facial Plast Surg 2018 Sep;20(5):401-408

Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota.

Importance: The clinical and financial implications of the timing of dental rehabilitation after a fibula free tissue transfer (FFTT) for osteoradionecrosis (ORN) and osteonecrosis (ON) of the mandible have yet to be established.

Objective: To compare the outcomes of primary implantation vs secondary implantation after FFTT for ORN and ON of the mandible.

Design, Setting, And Participants: A retrospective review was conducted of 23 patients at a single tertiary academic referral center undergoing primary implantation or secondary implantation after FFTT for ORN and ON from January 1, 2006, to November 10, 2015. Read More

J Reconstr Microsurg 2018 Oct 18;34(8):590-600. Epub 2018 May 18.

Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas.

Background:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. Read More

J Reconstr Microsurg 2018 Nov 12;34(9):719-728. Epub 2018 May 12.

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.

Background:  The superficial circumflex iliac artery (SCIA)-based iliac bone flap has yet to be widely used. The purpose of this article is to validate the feasibility of SCIA-based iliac bone flap transfers for reconstruction of small to moderate-sized bony defects. Retrospective outcome comparisons between SCIA-based iliac bone flaps and fibula flaps were made. Read More

Microsurgery 2019 Feb 7;39(2):182-187. Epub 2018 May 7.

Division of Plastic and Reconstructive Surgery, Mayo Clinic Hospital, Phoenix, Arizona.

Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. Read More

World J Plast Surg 2018 Jan;7(1):12-15

Department of Plastic Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Extended Soft tissue defect of leg including middle and distal parts always has been a challenge for many plastic surgeons and also a frustrated problem for patients and families. To introduce the use of the soleus muscle and reverse sural flaps as synchronous surgical treatment alternative of the leg bone exposure with large soft tissue defect, this study was conducted.

Methods: The medical records of patients undergoing transposition of the soleus muscle for treating exposed bone in the leg and simultaneous sural flap were retrospectively analyzed from January 2009 to July 2014, while gathering information on the used muscle was to cover the lesion. Read More

Int J Oral Maxillofac Surg 2018 Aug 23;47(8):983-989. Epub 2018 Mar 23.

Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan.

The purpose of this study was to evaluate surgical outcomes in elderly patients who had undergone free fibula flap transfer for malignant head and neck tumours. A retrospective chart review was performed to identify patients who had undergone free fibula flap transfer for mandibular reconstruction after malignant tumour resection at Jichi Medical University Hospital between May 2009 and April 2015. Enrolled patients were divided into an elderly group (≥80years old) and a younger group (<80years old). Read More

Aust Dent J 2018 03;63 Suppl 1:S108-S113

Royal Brisbane and Women's Hospital, University of Queensland, Herston Qld, Australia.

Prosthetic replacements in the 19th and early 20th century were superseded by pedicled flaps and obturators. These have subsequently been superseded by free tissue transfer which currently is the mainstay of reconstructive jaw surgery. Although malignant and benign processes of the jaws are the predominant cause of segmental defects, a significant proportion still occurs due to trauma, or even iatrogenic causes such as radiotherapy. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2018 Aug 2;135(4):279-282. Epub 2018 Mar 2.

Service de Chirurgie ORL et Cervico-faciale, Hôpital Foch, 40 rue Worth, 92150 Suresnes, France; Université de Versailles Saint-Quentin en Yvelines, UFR de Médecine Paris Ouest Saint-Quentin en Yvelines, Guyancourt 78280, France. Electronic address:

Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Read More

J Stomatol Oral Maxillofac Surg 2018 Sep 27;119(4):262-267. Epub 2018 Feb 27.

Department of Maxillo-facial, Plastic, Reconstructive and Aesthetic Surgery, Henri-Mondor Hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. Electronic address:

Introduction: Benefits of 3D printing techniques, biomodeling and surgical guides are well known in surgery, especially when the same surgeon who performed the surgery participated in the virtual surgical planning. Our objective was to evaluate the transfer of know how of a neutral 3D surgical modeling free open-source software protocol to surgeons with different surgical specialities.

Methods: A one-day training session was organised in 3D surgical modeling applied to one mandibular reconstruction case with fibula free flap and creation of its surgical guides. Read More

Microsurgery 2018 Jul 8;38(5):572-575. Epub 2018 Feb 8.

Plastic Surgery Department, Sant'Andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.

We present a case report of a 10-year-old girl diagnosed with Ewing sarcoma treated with intra-articular wide resection of the right femur and reconstruction with a series-connected double-barrel bilateral vascularized fibula graft (db-BVFG), including fibular head for articulation with the acetabulum of the pelvic bone and preservation of the epiphyseal growth plates for eventual limb growth. No postoperative complications were observed and bone union was achieved with fibular graft hypertrophy, allowing for full weight bearing. Neither local recurrence nor metastasis was observed at 17-year follow-up. Read More

Arch Orthop Trauma Surg 2018 May 7;138(5):653-660. Epub 2018 Feb 7.

Orthopedic Department, Benha University, El-Shaheed Farid Nada Street, Kafer el Gazar, Banha, Qalyubia, 13511, Egypt.

Introduction: Several reconstructive procedures have been used in management of large tibial bone defects including bone graft, bone transport (distraction osteogenesis) using various external fixators, and vascularized bone graft. Each of these procedures has its limitations and complications. The study describes gradual medial fibular transfer using Ilizarov external fixators in management of patients with large tibial defect, either following infection or trauma. Read More

J Oral Maxillofac Surg 2018 Jul 8;76(7):1571-1577. Epub 2018 Jan 8.

Department Head, Department of Anesthesiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address:

Purpose: Fibular free flap transfer is a powerful tool available to the reconstructive surgeon when treating oral and maxillofacial defects, but complications still occasionally occur and predictive analysis focusing on this specific flap is limited in terms of risk factors for complication. The purpose of this study was to identify key variables associated with complications in patients undergoing fibular free flap transfer.

Patients And Methods: The data of 163 consecutive patients who underwent fibular free flap surgery at the Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, between 2012 and 2015 were reviewed retrospectively. Read More

Curr Opin Otolaryngol Head Neck Surg 2018 Apr;26(2):127-133

Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Birmingham, West Midlands, UK.

Purpose Of Review: To review recent literature on the subject of free tissue transfer options in paediatric head and neck surgery, with a particular emphasis on highlighting the advantages and disadvantages of different reconstructions in the paediatric patient.

Recent Findings: Free tissue transfer in paediatric patients is predictable and applicable for a wide range of congenital and acquired defects in the head and neck. The free fibula flap is a mainstay of mandibular reconstruction and allows excellent implant-supported prosthodontic rehabilitation and growth potential at the recipient site with little or no donor site morbidity. Read More

BMC Res Notes 2017 Dec 28;10(1):769. Epub 2017 Dec 28.

Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang District, Chiang Mai, 50200, Thailand.

Background: Restoration of the lateral ankle after distal fibulectomy is a difficult reconstructive procedure. Many surgical techniques have been proposed. This report shows another fibular reconstructive option with promising outcome. Read More