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Page 8 of 10 Schaeffer et al. Plast Aesthet Res 2022;9:27 https://dx.doi.org/10.20517/2347-9264.2021.122

Table 1. Donor site morbidity following vascularized bone graft for lower extremity traumatic bone defects
Fibula Iliac crest MFC
EARLY COMPLICATIONS
Infection dehiscence necrosis Infection Altered sensation
Delayed wound healing Dehiscence hernia Hematoma seroma
Skin graft loss Delayed wound healing
Compartment syndrome
LATE COMPLICATIONS
Decreased ankle range of motion Altered sensation Persistent knee pain
Altered sensation Persistent pain Femur fracture
Persistent pain Gait disturbance
Claw toe
Ankle instability
Reduced muscle strength
Gait abnormality
Reduced muscle strength

MFC: Medial femoral condyle.

been described in the literature - immediate, often composite, free flap reconstruction vs. immediate soft
tissue coverage followed by second stage bony reconstruction [26-31] . Free fibula flaps provide the largest size
bone flap, ideal for larger bone defects and femur defects that would benefit from double-barreled
reconstruction . Vascularized iliac bone flaps provide less cortical bone for reconstruction, and are
[18]
therefore ideal for defects that are less than 10 cm in length. However, it can be harvested with associated
cancellous bone which can facilitate bony union [14,18-20] . MFC flaps are ideal for smaller bone defects, and can
be implemented in the setting of foot and ankle trauma .
[25]
DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design of the paper and provided mentorship and
revisions on the manuscript: Stranix JT
Performed literature review, composition of manuscript: Schaeffer CV

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Both authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2022.