Batting .500: Experience with the Fibular Free Flap in the Achondroplastic Patient

Objectives: To describe the use of the fibular free flap in the achondroplastic patient and to report the potential pitfalls of free flap surgery on this group of patients. Design: Retrospective chart analysis. Methods: We reviewed our experience with two fibular free flaps in this rare situation. Results: This is the largest series of fibular free flaps reported on the achondroplastic patient. An acute adrenal event resulted in hypothermia and hypotension and ultimately led to the failure of our first reconstructive attempt. Corrective measures were taken during the secondary reconstruction to prevent these systemic issues from coming into play, which ultimately led to a successful free fibular transfer. Conclusion: Free fibular transfer is possible for facial reconstruction in the achondroplastic patient, and success can be improved if measures are taken to prevent systemic complications of hypothermia and hypotension in the case of an acute adrenal event.