Effectiveness of the pedicled vascularized fibula graft to reconstruct tibial defects

Free vascularized fibula grafts have been used to reconstruct long tibial bone defects since Taylor's report in 1975. A pedicled vascularized fibula graft is also useful for small bone defects or pseudoarthrosis because of its excellent vascularity. The pedicled vascularized fibula transfer does not need the microvascular anastomosis and can be performed in much less time. It can be distally or proximally pedicled, depending on the site of the bone defect. A proximally or distally pedicled vascularized fibula with or without a monitoring flap was transferred in five cases of small bone defects and pseudoarthrosis of the tibia. In all 5 cases, the postoperative course was uneventful and good bony union was obtained.