LEG MORBIDITY AND FUNCTION FOLLOWING FIBULAR FREE-FLAP HARVEST

Over a period of 3 years, 50 consecutive free fibular flaps for mandib ular reconstruction were performed on 47 patients. In 38 patients (81% ) a skin paddle was included with the flap to provide either mucosal l ining or skin cover; in 9 patients (19%) bone alone was used. Thirty-o ne patients (66%) required a skin graft to close the donor defect in t he leg. Donor leg morbidity and function were determined by patient qu estionnaire and by physical examination. Forty-one donor sites in 40 p atients were available for long-term follow-up. The follow-up ranged f rom 4 to 39 months with an average of 17 months, Immediate postoperati ve infection occurred in the donor site of 1 patient (2%) and required additional surgery. There was no other immediate donor site complicat ions when closure required skin grafting. Eleven patients (27%) had la te donor site morbidity, consisting of motor weakness of the great toe in 5 patients, ankle instability and/or stiffness in 3 patients, dono r site pain in I patient, and edema in 2 patients, All complications w ere graded as mild in severity by the patient and by the examiner, In this series, although most donor site defects required skin grafting, short- and long-term morbidity was minimal. After a short rehabilitati on period, all patients were fully able to engage in all daily and rec reational activities.