ABSTRACT
-A retrospective analysis of 100 consecutive patients undergoing free fibula harvest
at the Mayo Clinic is presented. Every patient was analyzed by reviewing postoperative
physical examination data. All patients were evaluated and followed in the early postoperative
course by the physical medicine and 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 beyond the first 6 postoperative
weeks, with no donor-site complications clinically 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 ambulatory
distance to less than 1000 m. An additional six patients reported difficulty walking
stairs.
Attention to details and meticulous wound care are required to further reduce wound-healing
complications. Immediate postoperative involvement of the physical medicine and rehabilitation
services was beneficial in early patient mobilization and achievement of preoperative
ambulation levels. After a short rehabilitation period, the majority of patients were
able to engage in all daily activities.
