Fibula Musculo-Osteocutaneous Flap with Full Thickness of Flexor Hallucis Longus Muscle

Fibula flap has been a gold standard method for reconstruction of the mandible. It has been used for reconstruction of maxilla as well as long bones, effectively. Fibula flap in selected cases has been used as a pedicled flap. The flexor hallucis longus muscle has been used to obliterate the dead space during the reconstruction. With a wide range of indications, the use of flexor hallucis muscle has studied for the reconstruction. 

In a retrospective case record analysis study, 38 subjects were enrolled, included 32 patients with reconstruction of mandible, 1 patient with reconstruction of maxilla, 4 patients with 3 free flaps and 1 pedicled flap with reconstruction of the tibia. 

The success rate was 89%, with 4 flap failures. The muscle was used for reconstruction of the tongue, floor of the mouth, antrum, and to cover the fibula graft. 

Flexor hallucis longus muscle harvested with the flap could decrease the operative time, ease the harvest, and fill the dead space during reconstruction.