OSTEOCUTANEOUS FIBULAR FREE FLAPS IN COMPLEX UPPER LIMB TRAUMA

From 2005 to 2011 a total of 115 fibula free flaps were done; in this group there were seven patients with composite defects in the upper limb following acute trauma.2 of these reconstructions were for the humerus and 5 for loss of metacarpals in the hand. The length of the bony defect ranged from 4 cm to 10 cm. 2 patients had in addition replacement of segmental loss of radial nerve and partial loss of triceps muscle.1 of the 7 patients had a loss of the skin paddle 2 weeks postoperatively and needed a pedicled groin flap to cover the exposed viable fibular graft. Follow up period ranged from 1 years to 5 years. In all cases bony union was achieved without the need for secondary bone grafting.