title: Tibial stress fracture after fibular graft harvesting: an unusual complication.
abstract: BACKGROUND
  Fibular grafts are commonly used in reconstructive head and neck surgery, and several complications have been reported. Tibial stress fracture, however, is rare.
  
  
  METHODS
  A 65-year-old woman presented with a tibial stress fracture 10 weeks after a vascularized fibular flap had been harvested for a mandibular defect due to osteoradionecrosis. The main symptom was activity-related pain after a period of no complaints.
  
  
  CONCLUSIONS
  One should be aware of the complications, particularly after weeks or months, in cases of activity-related pain in the lower extremities. Prevention can be implemented by an awareness of the need to build up the muscles for supporting the tibia in the initial healing phase.
authors.affiliation: Department of Craniomaxillofacial and Oral Surgery, University Hospital Zurich, CH-8091 Zurich, Switzerland.
authors.forename: Ines
authors.initials: I
authors.lastname: Lison
authors.forename: Marius G
authors.initials: MG
authors.lastname: Bredell
authors.forename: Heinz T
authors.initials: HT
authors.lastname: Luebbers
authors.forename: Klaus W
authors.initials: KW
authors.lastname: Grätz
authors.forename: Astrid L D
authors.initials: AL
authors.lastname: Kruse
mesh_terms: D000368:Aged; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005593:Fracture Fixation, Internal / Q000379:methods*; D015775:Fractures, Stress / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008334:Mandible / Q000528:radiation effects / Q000601:surgery; D010025:Osteoradionecrosis / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery*; D013978:Tibial Fractures / Q000209:etiology* / Q000601:surgery*