Fibula Tissue Transfer

Excerpt

Autologous grafts have been fundamental to reconstruct bony defects for more than a century; the first description of free fibular graft transfer, however, was reported by Taylor et al. in 1975. More recently, the lateral approach to fibula harvest was popularized by Gilbert, followed by Chuang et al., who described free, vascularized fibula transfer with a skin paddle and functional soleus muscle for forearm reconstruction.

Numerous options exist to reconstruct bony defects, including nonvascularized cancellous and cortical autografts, cadaveric bone allografts, endoprosthesis placement, bone transfer procedures, and vascularized bone grafts as well, such as iliac crest, rib, scapula, and fibula. Free vascularized fibular grafting is widely utilized for reconstructing skeletal defects larger than 6 cm due to the fibula's length, straightness, strength, predictable vascular pedicle, and hypertrophy potential that can enhance long-term bone remodeling.

Nowadays, a fibular transfer is commonly utilized after tumor surgery, pseudarthrosis rescue, mandibular defect reconstruction, and chronic osteomyelitis management. A vascularized epiphyseal transfer is used for reconstruction in skeletally immature patients with complex injuries in order to preserve the potential for ongoing longitudinal growth and provide a viable articular surface for effective joint function.