ABSTRACT
The fibula is a long slender triangular-shaped bone that is said to have two functions: ankle joint stability and microvascular reconstruction of bony defects. It is mainly composed of cortical bone, giving it great stability. 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. The first vascularised fibula flap transfer was used for ulnar reconstruction by Ueba in 1974. Taylor et al. subsequently reported free fibula transfer for two tibial defects. The fibula is supplied by periosteal branches of the peroneal artery, and by an endosteal vessel which directly enters the bone at the middle third/distal third junction. In maxillofacial surgery, the fibula flap is mainly used for primary or secondary reconstruction of extensive mandibular and maxillary bone defects.
