Experience of Saving Limbs With Free Fibula Osteocutaneous Flaps.

Background Complex wounds of hands and feet have always been a challenge for reconstructive surgeon. We aim to share our experience of reconstruction of such defects using free fibula osteocutaneous flaps. Materials and methods This is a retrospective study over a period of six years which was conducted at a tertiary care teaching hospital in Karachi. All patients, who were included and had reconstruction with this flap, agreed to participate in this study. Hospital records were retrieved for patient's demographic details, mode of injury, size of the defect, number of bone loss in the defect, dimensions of flap, size and number of bony segments in each flap. Outcomes were recorded in terms of flap survival and secondary procedures, with post-operative radiographs. Results In 14 patients, 25 (80.5%) metacarpals and 6 (19.5%) metatarsals defects were reconstructed. K-wires were used for bony stabilization and were removed at 8 weeks post-operatively. Only two flaps were re-explored due to venous congestion. Minor wound dehiscence was noted in two flaps which were managed conservatively. Conclusion Proper planning and meticulous flap dissection and inset using free fibula flap can save many hand and foot from amputations.