A retrospective analysis of 100 consecutive patients undergoing free fibula
harvest at the Mayo Clinic is presented. Every patient was analyzed by rev
iewing postoperative physical examination data. All patients were evaluated
and followed in the early postoperative course by the physical medicine an
d rehabilitation services. Patients were followed from 3 to 60 months, with
an average follow up of 17.42 months. In the patient group, 72 flaps were
osseous and 28 osteocutaneous.
Thirty-six complications at the donor site were observed in 30 patients. An
additional 19 patients required prolonged pharmacologic pain control beyon
d the first 6 postoperative weeks, with no donor-site complications clinica
lly detectable. Hammertoe was observed in six patients and wound dehiscence
in seven patients. Tendon exposure was observed in five patients; partial
split-thickness skin graft loss was observed in eight. Numbness of the foot
was reported in 10 patients. Fifteen patient had limited maximum ambulator
y distance to less than 1000 m. An additional six patients reported difficu
lty walking stairs.
Attention to details and meticulous wound care are required to further redu
ce wound-healing complications. Immediate postoperative involvement of the
physical medicine and rehabilitation services was beneficial in early patie
nt mobilization and achievement of preoperative ambulation levels. After a
short rehabilitation period, the majority of patients were able to engage i
n all daily activities.