Leg morbidity and function following fibular free flap harvest.
Over a period of 3 years, 50 consecutive free fibular flaps for mandibular reconstruction were performed on 47 patients. In 38 patients (81%) a skin paddle was included with the flap to provide either mucosal lining or skin cover; in 9 patients (19%) bone alone was used. Thirty-one patients (66%) required a skin graft to close the donor defect in the leg. Donor leg morbidity and function were determined by patient questionnaire and by physical examination. Forty-one donor sites in 40 patients were available for long-term follow-up. The follow-up ranged from 4 to 39 months with an average of 17 months. Immediate postoperative infection occurred in the donor site of 1 patient (2%) and required additional surgery. There was no other immediate donor site complications when closure required skin grafting. Eleven patients (27%) had late donor site morbidity, consisting of motor weakness of the great toe in 5 patients, ankle instability and/or stiffness in 3 patients, donor site pain in 1 patient, and edema in 2 patients. All complications were graded as mild in severity by the patient and by the examiner. In this series, although most donor site defects required skin grafting, short- and long-term morbidity was minimal. After a short rehabilitation period, all patients were fully able to engage in all daily and recreational activities.
Shpitzer
T
T
Division of Plastic Surgery, University of Toronto, Ontario, Canada.
Neligan
P
P
Boyd
B
B
Gullane
P
P
Gur
E
E
Freeman
J
J
D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D005260:Female; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D007866:Leg / Q000502:physiology; D008297:Male; D008334:Mandible / Q000601:surgery*; D008336:Mandibular Diseases / Q000601:surgery*; D008875:Middle Aged; D009017:Morbidity; D013524:Surgical Flaps / Q000379:methods*; D016896:Treatment Outcome