The fibular osteocutaneous free flap is a type D flap originally described for use in mandibular reconstruction by Hidalgo et al. in 1989 (44). The fibular bone is composed largely of thick cortical bone and is tubular in shape. It is perfectly straight and must be osteotomized to fit most mandibular defects. The skin over the lateral leg can be harvested with the underlying fibular bone as a sensate soft tissue flap. The width of skin available is up to 6 cm (while still allowing primary closure of the donor site), and the length of skin available may be up to 25 cm (Fig. 36).
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