A free fibula autologous transfer for a full-thickness anterior chest wall defect

Large defects of the anterior chest wall lead to gross chest instability which can result in paradoxical respiration. Skeletal stabilization is an essential requirement in such cases. The current methods for achieving total or near total sternal reconstructions involve the use of alloplastic implant materials: prosthetic mesh with methyl methacrylate. In our experience, this method of reconstruction is often complicated by a persistent seroma and infection. A large full-thickness sternal defect was reconstructed by an osteotomized free fibula "Z" transfer and bilateral bipedicled pectoralis major myocutaneous flaps. This case highlights the use of vascularized autologous tissue for a complex full-thickness anterior chest wall reconstruction.