The free vascularised fibula flap has become one of the most popular choices in head and neck composite reconstruction. One of the reasons for this is its relatively low morbidity. The literature suggests toe flexion as one of the noted complications of this surgery. It is not clear however whether removal of flexor hallicus longus (FHL) is the cause for this. In our practice, the FHL is removed if a skin paddle is required, but spared if a bone only flap is utilised. A morbidity questionnaire for 26 flaps was carried out including a star score to determine whether removal of FHL was a cause for this complication. The results suggest that removal of FHL does not cause significant flexion deformity.
FHL—the cause for morbidity in fibula free flap transfer?
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