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Arch Hand Microsurg > Volume 24(2); 2015 > Article
Archives of Hand and Microsurgery 2015;24(2):68-74.
Published online November 30, 2015.
Reconstruction of Large Femur and Tibia Defect with Free Vascularized Fibula Graft and Locking Plate
Min Bom Kim, Young Ho Lee*, Jeong Kook Baek, Ho Sung Choi, and Goo Hyun Baek
Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea.
Received: 29 October 2015   • Revised: 23 November 2015   • Accepted: 24 November 2015


The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported.

Materials and Methods:

Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates.


All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively.


VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects.

Key Words: Free vascularized fibula graft, Reconstruction, Locking plate, Bone defect

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