What is the maximum length of defect that can be repaired using a fibula free flap?

The fibula free flap is a versatile and widely used method for reconstructing defects in the oral and maxillofacial region, particularly for the mandible. One of the significant advantages of using the fibula is its length and the ability to tailor it to suit various defect sizes. It can typically provide a bone segment that measures up to 25 cm.

This length makes the fibula flap a suitable choice for extensive reconstructions, especially in cases where there are substantial bone losses due to trauma, tumor resection, or other pathologies. The fibula not only offers structural support as a vascularized bone graft, but its associated soft tissue, including skin and muscle, further enhances the surgical outcome by allowing for simultaneous soft tissue coverage.

Choosing an appropriate flap is crucial, and while the fibula free flap is exceptionally effective for reconstructive needs, it is essential to consider factors such as the overall vascularity of the flap, patient anatomy, and the specific area being reconstructed. The maximum length achievable with the fibula free flap supports its use in challenging reconstructive scenarios where larger defects need to be addressed effectively and safely.