Functional osteomuscular free-tissue transfer: The reinnervated fibula-flexor hallucis longus free flap

Limb salvage after tumor resection or after trauma with massive bone and soft-tissue defects tends to be challenging for the reconstructive surgeon. It is even more so if a combination of bone, soft-tissue coverage, and muscle function is required for complex reconstructions within one operation with one composite free flap. In one patient, we successfully used the combined transfer of the flexor hallucis longus muscle for functional reinnervation with a fibula segment on one pedicle. This article describes the anatomical and technical details of this new reconstructive option.