Free Vascularized Fibular Graft in Reconstruction of Critical Defects of Long Bones

Background: Reconstruction of long bone defects remains a challenging issue in orthopaedic surgery, especially in cases of trauma and infection. Free vascularized fibular graft (FVFG) offers a viable solution due to its intrinsic blood supply, promoting rapid healing and graft hypertrophy.Objective: To evaluate the clinical and functional outcomes of FVFG in patients with long bone defects.Methods: A prospective study was conducted on 30 patients treated with FVFG for segmental long bone defects. Demographic data, pathology, defect characteristics, fixation methods, and outcomes, including union rate, time to union, hypertrophy, complications, donor site morbidity, and functional scores (DASH and LEFS), were analysed. Statistical analysis employed non-parametric tests and correlation assessments.Results: The cohort consisted predominantly of males (73.3%) with a mean age of 31.7 years. Defects involved mainly the upper limb, with a mean defect length of 12.3 cm. Union was achieved in the majority, with a mean time to union of 5.7 months. Complication rates and donor site morbidity were low. Functional outcomes showed moderate disability via DASH scores. No significant correlation was observed between patient age or defect size and union time.Conclusion: FVFG is a safe and effective technique for reconstructing long bone defects, offering high union rates, manageable complications, minimal donor morbidity, and satisfactory functional recovery. This method should be considered a primary reconstructive option in complex limb salvage cases.