We evaluated the results of skeletal reconstruction performed through a
mature, vascularized fibular graft in five patients. The average
time-interval between the original transplant and the secondary
reconstruction was sixty-eight months. The indication for the initial graft
had been the loss of bone secondary to trauma in one patient, a skeletal
defect due to ablation of a tumor in two patients, and osseous loss due to
resection of a congenital pseudarthrosis in two patients. The indication
for the second reconstruction was non-union of a fracture as a result of a
new traumatic injury in two patients and complex angular deformity in three
patients; one of the patients in the latter group had an associated
leg-length discrepancy. In all five patients, the second reconstruction was
successful, and the vascularized fibular graft responded to the procedure
in a manner similar to normal cortical bone.