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The authors present a novel approach using a vascularized double-barrel fibula flap combined with an intramedullary nail (IMN) to reconstruct critical-size segmental tibial defects. Current methods, such as bone transport or induced membrane techniques, require multiple procedures and are associated with high complication rates and delayed load bearing. We present the case of a 44-year-old man with nonunion and chronic osteomyelitis of the left tibia, who underwent reconstruction with a contralateral double strut free fibula flap, placement of IMN, and cancellous bone grafting. The patient had an uncomplicated postoperative course and achieved full weight-bearing in 4.5 months. This method provides a single-stage, effective reconstruction overcoming limitations of traditional techniques.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153277 | PMC |
http://dx.doi.org/10.1097/GOX.0000000000006859 | DOI Listing |
J Surg Case Rep
September 2025
Department of Plastic Surgery and Hand Surgery, HOCH, Kantonsspital St Gallen, Rorschacherstrasse 95, 9007 St Gallen, Switzerland.
Vascularized reconstruction of bone defects in the foot after osteomyelitis is a complex procedure that requires an orthoplastic collaboration. This case demonstrates the successful use of a free osteocutaneous fibula flap with a perforator-based skin island to reconstruct the medial midfoot following a late-onset infection after fusion for osteonecrosis. A 63-year-old woman presented after osteonecrosis and failed surgeries, including talonavicular and naviculocuneiform arthrodesis complicated by infection.
View Article and Find Full Text PDFSupport Care Cancer
September 2025
Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250014, China.
Objective: This study examines the effects of preoperative oral carbohydrates on the perioperative period of Fibula Free Flap surgery in oral cancer patients, aiming to enhance postoperative recovery.
Methods: The study involved 89 patients who underwent fibula flap reconstruction surgery from January to December 2023. Patients were divided into control and experimental groups based on admission time.
JPRAS Open
December 2025
Division of Plastic Surgery, Department of Surgery, University of Texas Health Science Center, San Antonio, TX, USA.
Introduction: The free fibula flap is a workhorse flap for bony reconstruction of the craniofacial skeleton. The aim of the study was to conduct a systematic review to investigate the postoperative donor site complications and functional outcomes, specifically ankle instability (AI) and gait disturbances (GD), for patients who have received a free fibula flap (FFF) for head and neck cancer reconstruction.
Methods: We designed a PRISMA-compliant systematic review, which was registered prospectively in PROSPERO.
J Craniomaxillofac Surg
September 2025
Christian Albrechts University, Department of Oral and Maxillofacial Surgery, UKSH- Campus Kiel, Kiel, Germany.
Robotic surgery has undergone steady evolution in recent years. Until now, there has been no suitable robotic system for plastic reconstruction. With the Symani Surgical System, anastomoses of free flaps in the head and neck region can be performed efficiently and accurately.
View Article and Find Full Text PDFBMC Musculoskelet Disord
September 2025
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, China.
Background And Objective: Chronic osteomyelitis of long diaphyseal bones often results in extensive structural bone defects following debridement. Traditional approaches such as cancellous bone grafting, fibular transplantation, the classical Masquelet technique, and the Ilizarov method each have inherent limitations when used alone, particularly for defects exceeding 10 cm. This study aimed to evaluate a modified Masquelet technique, in which the induced membrane cavity is reconstructed using vascularized fibular grafts, for the management of ultra-long segmental bone defects.
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