Fibula Tissue Transfer

Bone grafts have been the backbone of reconstruction of bony defects for more than a century. The first description of a free fibular graft transport was made by Taylor et al in 1975. Posteriorly, a lateral dissection approach to the free fibula was published by Gilbert, followed by Chuang et al who described fibula transport with a skin paddle for forearm reconstruction by using functioning muscle (lateral half of the soleus).Several reconstructive procedures have been proposed for a variety of procedures e.g Nonvascularized cancellous and cortical autografts, cadaveric bone allografts, endoprosthesis replacement, bone transport procedures, as well as vascularized bone grafts such as iliac crest, rib, and fibula graft have been attempted. Free vascularized fibular graft (FVFG) is widely utilized for covering skeletal defects larger than 6 cm due to the long cylindrical straight shape, mechanical strength, predictable vascular pedicle, and hypertrophy potential that enhance a proper bone remodeling.Nowadays, the fibular graft is being utilized to treat large bone stock deficit after tumor surgery, as pseudarthrosis rescue procedure, mandibular defects reconstruction, and chronic osteomyelitis management. The vascularized epiphyseal transfer is being used for skeletally immature patients with complex injuries in order to preserve the ongoing longitudinal growth allowing a reliable articular surface for effective joint function.