Free vascularized fibular graft: a versatile graft for reconstruction of large skeletal defects and revascularization of necrotic bone.

The microvascular transfer of a fibular graft that was initially introduced for the treatment of massive bone loss in the appendicular skeleton has more recently found another useful application in the management of the osteonecrosis of the femoral head. Since 1989, we have successfully used the free vascularized fibula in two patients with segmental bone loss, one in the forearm and the other in the distal femur. We have also attempted revascularization of the femoral head in fifteen patients (eighteen hips) with osteonecrosis. Although our follow-up is short, the results have been encouraging and this method is now the treatment of choice in the early stages of the disease.