This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ruch, D. S. Articles by Koman, L. A. Search for Related Content PubMed PubMed Citation Articles by Ruch, D. S. Articles by Koman, L. A.

THE FIBULA-FLEXOR HALLUCIS LONGUS OSTEOMUSCULAR FLAP

Bowman Gray School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1070, USA.

Correspondence should be sent to Dr D. S. Ruch.

Limb salvage after loss of bone and soft tissue may require many operations to obtain soft-tissue cover and bony continuity. We describe a fibula-flexor hallucis longus osteomuscular flap which can provide both soft tissue and bone in a single stage. The flap is based on the peroneal vessels and is covered by a split-thickness skin graft.

We report the results in five patients with an average bone defect of 8.3 cm and soft-tissue and skin loss. All regained a normal gait on the donor side; four had clinical and radiological union with excellent soft-tissue cover, but one required later amputation due to diffuse coagulopathy.

The flap provides free vascularised bone with muscle cover. It has a dependable, long pedicle with minimal morbidity at the donor site, and allows monitoring of the vascularity of the fibular graft.