ABSTRACT
The first vascularized fibula flap transfer was used for ulnar reconstruction by Ueba in 1974. The advantages of the fibula are that it offers an abundant supply of tubed bi-cortical bone, which is useful for reconstruction of long segmental defects across the midline – 25 cm or more of bone can be harvested. In maxillofacial surgery, the fibula flap is mainly used for primary or secondary reconstruction of extensive mandibular bone defects. When greater depth of bone is required in large mandibular defects, it may be possible to fold the bone back on itself or perform interval distraction osteogenesis. The flap can also be used for congenital malformations, and some have recommended its use in pre-prosthetic surgery. With the advent of computer-assisted design and computer-assisted manufacture technology and rapid prototyping modelling, surgical planning for fibula flaps has evolved to a very precise procedure.
