Pedicled osteocutaneous fibula flap for reconstruction in the lower extremity

Replacement of bony defects in the distal femur or proximal tibia can be difficult, especially if complicated by infections or soft-tissue defects. The vascularized fibula flap can provide the amount of bony tissue needed to fill such defects, and the soft-tissue coverage can be supplied by the skin territory of the flap based on perforators from the peroneal artery. Four patients with complicated defects of distal femur and proximal tibia treated with an ipsilateral fibula osteoseptocutaneous pedicled flap are presented.