title: Reconstruction of a tibial defect with a previously fractured fibula including the fractured segment as a free osteoseptocutaneous flap.
abstract: BACKGROUND
  Reconstruction of major bone defects using free fibular transfer provides a good biological option in unsound situations. Most authors recommend selection of the recipient blood vessels outside the zone of injury to achieve successful free fibular transfer. Occasionally, in polytraumatized patients, the surgeon has to use a previously fractured fibula as a graft, with increased risk of inclusion of the injury zone that may lead to failure.
  
  
  METHODS
  We report a rare case of successful reconstruction of a large tibial defect using a previously fractured fibula as a free osteoseptocutaneous flap. The innovative point in our case is the inclusion of the fracture site within the utilized segment, which to our knowledge has never been reported.
  
  
  CONCLUSIONS
  As long as the microsurgical principles are adhered to, the effect of the zone of injury on the graft viability should not be overwhelming.
authors.affiliation: From the *Orthopedic Surgery Department, El-Minia University Hospital, El Minia, Egypt; †Reconstructive Sciences Unit, and ‡Orthopedic Department, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
authors.forename: Ahmed Fathy
authors.initials: AF
authors.lastname: Sadek
authors.forename: Ahmad Sukari
authors.initials: AS
authors.lastname: Halim
authors.forename: Faisham Wan
authors.initials: FW
authors.lastname: Ismail
authors.forename: Yusof M
authors.initials: YM
authors.lastname: Imran
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D005360:Fibula / Q000293:injuries / Q000637:transplantation*; D005597:Fractures, Open / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013978:Tibial Fractures / Q000601:surgery*; D055815:Young Adult