Long bone reconstruction with vascularized bone grafts

The vascularized fibula may be used for long bone reconstruction reliably and successfully. Since its description by Taylor, the fibula flap has evolved to solve a myriad of long bone reconstructive dilemmas. The flap is used routinely for non-unions, postoncologic resections, and congenital defects. It provides faster and more reliable union than nonvascularized grafts. When constructed in a double-barrel configuration, it offers the ability to bear weight. The vascularized fibula can be used to maintain growth by virtue of transferring the physis. The vascularized fibula is thus both the workhorse and thoroughbred in long bone reconstruction.