UNASSIGNED: The fibula free flap is ideal for complex jaw reconstructions, with low reported donor and flap morbidity. We discuss a distal tibial stress @entity174 two months following a vascularised fibula free flap procedure. Despite being an unrecognised complication, a literature review produced 13 previous cases; only two were reported in the reconstructive surgery literature, with the most recent claiming to be the first. The majority of these studies treated this @entity174 non-operatively; none reported their @entity1 follow-up. Each case presented with ipsilateral @entity158 , which has been cited as an early donor site morbidity in as many as 40% of fibula free flap cases. It is known that the fibula absorbs at least 15% of leg load on weight bearing. Studies have shown severe @entity85 in up to 25% of @entity1 with fibulectomies. We treated our @entity1 operatively, first correcting his worsening @entity85 with an external fixator, then reinforcing his healed @entity174 with a long distal tibial plate. We believe that this complication is underreported, unexpected and not mentioned during the consenting process. By highlighting the management of our case and the literature, we aim to increase awareness (and thus further reporting and appropriate management) of this debilitating complication.

XXXX are a poorly recognised complication with fibula free flaps.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity85 :: ('MESH:D009140', 'Disease') :: ['valgus deformities', 'valgus deformity'] @entity158 :: ('MESH:D010146', 'Disease') :: ['leg pain'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture']
@entity174 :: (MESH:D050723,Disease) :: ['Distal tibial fractures']
