Risk Factors for Early and Late Donor-Site Morbidity After Free Fibula Flap Harvest

Abstract

This article reports on the incidence of donor-site complications and identifies predictive factors for early and late donor-site complications. From January 2007 through December 2012, 45 patients underwent free fibula flap reconstruction and their medical records were reviewed. They were asked to complete a questionnaire on the operated leg and they were evaluated for ankle stability and ambulatory status. One patient (2.2%) developed a complication owing to a hematoma, but no other patients had any complications. During the risk factor analysis, no domain was found to be statistically associated with early morbidity; late dysfunction was noted in 20 patients (57.1%), and of these cases, at least 2 symptoms were found in 10 patients (50%). The most common complication was numbness followed by toe contracture and abnormal ambulatory movement. During the risk analysis, the following domains affected late donor-site morbidity: harvested fibula length, operation time, and follow-up time. Furthermore, in cases with complications, patients with the osteocutaneous fibula flap complained more than patients with the osseous flap (P = .07). Early donor-site morbidity was uncommon, but late morbidity occurred frequently. Harvested fibula length, operation time, and follow-up time were statistically linked to postoperative function.