Propeller Flap Closure Is Superior To Skin Grafts For Reconstruction Of The Osteocutaneous Fibula Flap Donor Site: Anatomical Considerations And Outcomes

 

➢ The osteocutaneous fibula free flap (OCFFF) first introduced by Hidalgo1 is currently the
gold standard for composite maxillomandibular reconstruction.
➢ The fibula bone provides excellent bone stock, and the overlying leg skin provides adequate
soft tissue for intraoral or external resurfacing.2–4
➢ Appropriate reconstruction of the lower leg donor site after skin paddle harvest is critical to
minimize functional morbidity and optimize aesthetic outcomes.
➢ Traditionally, skin grafts have been utilized where primary closure is not possible. However,
they are associated with short- and long-term morbidity, including delayed healing and
poor aesthetic results.
➢ The use of local propeller flap reconstruction has been described in the literature to
address these limitations.5–10
➢ Local propeller flaps in the lateral leg are typically based on either the perforators arising
from the posterior tibial or the peroneal vessels.
➢ Given that the peroneal artery is sacrificed during a fibula flap harvest, using propeller flaps
in this context poses challenges and is sometimes not feasible.
➢ While a few previous studies have detailed their experience with using propeller flaps for
fibula donor site closures, no study to date has clearly demonstrated the anatomic
considerations and indications.
OBJECTIVE