title: Pedicled fibular flap for reconstruction of composite defects in foot.
abstract: BACKGROUND
  Reconstruction of complex injuries involving bone and soft-tissue in foot remains a tough challenge for surgeons. The free fibular flap is a popular flap for treating these composite defects. However, complications caused by microvascular anastomoses are not uncommon. Herein, we designed a pedicled fibular flap elevated in the ipsilateral leg for reconstruction of multiple defects in foot.
  
  
  METHODS
  From July 2005 to April 2013, four patients with composite defects in foot were treated by pedicled fibular flaps. The defects were located in the first metatarsal bone and medial cuneiform bone in two patients, in the fourth metatarsal bone in one patient, and in the second to fourth metatarsal bones in one patient. The size of soft-tissue defects ranged from 10×7 cm to 15×7 cm, and the length of bone defects ranged from 6 to 8 cm.
  
  
  RESULTS
  The length of fibular grafts ranged from 7 to 8.5 cm, and the size of skin flaps ranged from 11×8 cm to 16×8 cm. All flaps survived completely. Complications occurred in two patients. One suffered moderate venous congestion and the flap survived without intervention. The other one sustained re-infection. Debridement was performed and the wound healed uneventfully. Follow-up ranged from 8 to 32 months. Bone union occurred at an average of 12 weeks, and the skin flaps showed good cosmetic results. No serous donor-site complications occurred.
  
  
  CONCLUSIONS
  The pedicled fibular flap transfer could avoid anastomosis complications and preserve healthy limb. It is a good option for reconstruction of complex defects in foot.
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Chun-Yang
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Pei
authors.initials: P
authors.lastname: Han
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. Electronic address: Chaiyimin@outlook.com.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Chai
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Sheng-Di
authors.initials: SD
authors.lastname: Lu
authors.affiliation: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Wan-Run
authors.initials: WR
authors.lastname: Zhong
mesh_terms: D000328:Adult; D003646:Debridement; D005360:Fibula / Q000637:transplantation*; D018409:Foot Injuries / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome
keywords: Fibular flap; Foot injury; Microsurgery; Pedicled flap; Reconstruction