title: The fibula-flexor hallucis longus osteomuscular flap.
abstract: Limb salvage after loss of bone and soft tissue may require many operations to obtain soft-tissue cover and bony continuity. We describe a fibula-flexor hallucis longus osteomuscular flap which can provide both soft tissue and bone in a single stage. The flap is based on the peroneal vessels and is covered by a split-thickness skin graft. We report the results in five patients with an average bone defect of 8.3 cm and soft-tissue and skin loss. All regained a normal gait on the donor side; four had clinical and radiological union with excellent soft-tissue cover, but one required later amputation due to diffuse coagulopathy. The flap provides free vascularised bone with muscle cover. It has a dependable, long pedicle with minimal morbidity at the donor site, and allows monitoring of the vascularity of the fibular graft.
authors.affiliation: Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1070, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Ruch
authors.forename: L A
authors.initials: LA
authors.lastname: Koman
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001132:Arm / Q000601:surgery*; D001859:Bone Neoplasms / Q000601:surgery; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D005260:Female; D005268:Femoral Vein; D005360:Fibula / Q000098:blood supply; D005684:Gait; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D012516:Osteosarcoma / Q000601:surgery; D011826:Radial Nerve / Q000293:injuries / Q000601:surgery; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply; D013530:Surgical Wound Infection / Q000601:surgery; D013927:Thrombosis / Q000209:etiology / Q000601:surgery; D013977:Tibia / Q000601:surgery; D013978:Tibial Fractures / Q000601:surgery; D014654:Vascular Patency; D014945:Wound Healing; D014948:Wounds, Gunshot / Q000601:surgery