Tibia Stress Fracture and Subsequent Nonunion Associated With High Morbidity Following Vascularized Fibula Graft Harvest

Abstract

There is little in the literature about tibial stress fracture after partial fibulectomy. As fibula strut grafting and vascularized fibula flap grafting becomes more common in the field of reconstructive surgery, the incidence of this complication will likely rise. The authors present the case of a 54-year-old woman with tibial stress fracture and subsequent nonunion following vascularized fibula graft harvest. The aim of this case report is to present a unique tibial stress fracture and nonunion following vascularized fibula flap for mandibular reconstruction and a discussion of the orthopedic management of this uncommon injury. The authors' goal is to educate both surgeons and patients about the altered biomechanics and subsequent risks associated with fibula strut graft harvest, from an orthopedic surgery perspective. By increasing physician awareness and obtaining better informed consent preoperatively, better health care outcomes associated with fibular graft harvesting can be obtained. [Orthopedics. 2021;44(2):e306-e308.].