{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:56:59Z","timestamp":1793235419996,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T00:00:00Z","timestamp":1683849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Free vascularized fibula flap represents the gold standard vascularized bone graft for the management of segmental long bone defects after traumatic injury. The current study represents the largest retrospective multicenter data collection on the use of free fibula flap (FFF) for extremities' orthoplastic reconstruction after trauma aiming to highlight current surgical practice and to set the basis for updating current surgical indications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study is designed as a retrospective analysis of prospectively collected data between 2009 and 2021 from six European University hospitals. Patients who underwent fibula flap reconstruction after acute traumatic injury (AF) or as a late reconstruction (LF) after post\u2010traumatic non\u2010union of upper or lower limb were included. Only extra\u2010articular, diaphyseal fracture were included in the study. Surgical data were collected. Time to bone healing and complications were reported as clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010two patients were included in the study (27 in the AF group and 35 in the LF group). The average patients' age at the time of the traumatic event was 45.3\u2009\u00b1\u20092.9\u2009years in the AF group and 41.1\u2009\u00b1\u20092.1\u2009years in the LF group. Mean bone defect size was 7.7\u2009\u00b1\u20090.6\u2009cm for upper limb and 11.2\u2009\u00b1\u20091.1\u2009cm (<jats:italic>p<\/jats:italic>\u2009=\u2009.32) for lower limb. Bone healing was uneventful in 69% of treated patients, reaching 92% after complementary procedures. Bone healing time was 7.6\u2009\u00b1\u20091.2\u2009months in the acute group and 9.6\u2009\u00b1\u20091.5\u2009months in the late group. An overall complication rate of 30.6% was observed, with a higher percentage of late bone complications in the LF group (34%), mostly non\u2010union cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>FFF reconstruction represents a reliable and definitive solution for long bone defects with bone healing reached in 92% cases with a 8.4\u2009months of average bone healing time.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.31054","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T10:29:46Z","timestamp":1683887386000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Orthoplastic limb reconstruction using free fibula flap after trauma: Outcomes from a retrospective European multicenter study"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1431-4479","authenticated-orcid":false,"given":"Pietro G.","family":"Di Summa","sequence":"first","affiliation":[{"name":"Department of Plastic and Hand Surgery Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL)  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"de Schoulepnikoff","sequence":"additional","affiliation":[{"name":"Department of Plastic and Hand Surgery Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (UNIL)  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Guillier","sequence":"additional","affiliation":[{"name":"Department of Plastic and Maxillo\u2010facial Surgery University Hospital of Dijion  Dijion France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Cigna","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, Plastic Surgery Unit University of Pisa  Pisa 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