Introduction and purpose: Large defects of diverse aetiology (traumatic, oncological, etc.) in long bones pose a number of difficulties for reconstruction because of their dual condition: structural and functional.

The free fibular flap can be a useful method for reconstructing large defects in bones such as the tibia or humerus.

We present our experience with 15 patients in whom this bone flap was used to reconstruct defects of different pathological origins.

Materials and methods: Retrospective analysis of 15 patients between the ages of 6 and 55 in whom a vascularised fibular flap was used to reconstruct bone defects in the following locations and pathologies: Tibia: 7 cases of congenital pseudoarthrosis, 1 case of posttraumatic pseudoarthrosis, 1 case of firearm wound, 1 case of chronic osteomyelitis, 2 cases of Ewing’s sarcoma in the distal third of the tibia; Humerus: 2 cases of Ewing’s sarcoma; Radius: 1 case of osteosarcoma. Of the 15 cases 14 fibulae were used with a single bar, with different attachment methods, and one with a double bar.

Results: The viability rate of the flaps was 100%, and adequate function was achieved in all cases except one case of posttraumatic pseudoarthrosis that required further procedures.

Conclusions: The vascularised fibular flap is the best option for treating congenital pseudoarthrosis of the tibia and a good option for reconstruction after oncological bone surgery.