Dmitry Ladutko, surgeon of the microsurgical department, Minsk Regional Clinical Hospital;
Vladimir Podgaysky, Head of the Department of plastic surgery and combustiology, BelMAPO, Doctor of Medical Sciences, professor;
Yuri Ladutko, associate professor of the Department of traumatology and orthopedics, BelMAPO, Candidate of Medical Sciences;
Oleg Kezlya, Head of the Department of traumatology and orthopedics, BelMAPO, Doctor of Medical Sciences;
Andrey Pekar, surgeon of the microsurgical department, Minsk Regional Clinical Hospital;
Anton Selitsky, senior lecturer, Department of traumatology and orthopedics, BelMAPO.

Summary.
There was studied the degree of graft hypertrophy, the rate of its fusion with the recipient bed, and the number of postoperative complications under different conditions of mechanical stimulation of the fibula graft. According to the results of the study, it was shown that the fusion rate of the transplanted fibula with the bone bed does not depend on the method of limb fixation, but early postoperative loading accelerates the process and reduces the likelihood of developing complete stress fractures in the future.
Key words: bone defect, vascularized fibula grafts, hypertrophy, stress fractures.
References.
1. Ruchkina, I.V., Osipova, E.V., Dyachkov, A.N. Rentgenodensitometricheskie osobennosti formirovaniya regenerata v kostnom defekte, izolirovannom ot myagkikh tkaney rezorbiruemym materialom (eksperimental'noe issledovaniye) // Geniy Ortopedii. – 2003. – N 4. – P. 35. In Russian
2. Gugala, Z., Lindsey, R.W, Gogolewski, S. New approaches in the treatment of critical-size segmental defects in long bones. // Macromolecular Symposia. – 2007. – P. 253, 147–161.
3-4. Houdek, M.T., Bayne, C.O., Bishop, A.T., Shin, A. Yong-Shik. The outcome and complications of vascularised fibular grafts// The bone & joint journal. – 2017. – Vol. 99-B, N 1. – Р. 134–138.
5. Falder, S., Sinclair, J.S., Rogers, C.A., Townsend, P.L.G. Long-term behaviour of the free vascularised fibula following reconstruction of large bony defects // British Journal of Plastic Surgery. – 2003. – Vol. 56, iss.6. – P. 571–584.
6. Zelenski, N., Brigman, B.E, Levin, L.S, Erdmann, D., Eward, W.C. The vascularized fibular graft in the pediatric upper extremity: a durable, biological solution to large oncologic defects // Sarcoma, 2013.
7. Rodomanova, L.A. Vozmozhnosti rekonstruktivnoy mikrokhirurgii v rannem lechenii bol'nykh s obshirnymi posttravmaticheskimi defektami konechnostey/Thesis of a doct. diss. – St. Petersburg, 2010. In Russian
8. Tikhilov, R.M., Kochish, A.Yu., Rodomanova, L.A., Razorenov, V.L., Kozlov, I.V. Sovremennye tendentsii plastiki loskutami s osevym tipom krovosnabzheniya na nizhney konechnosti// Vestnik travmatologii i ortopedii im. N.N. Priorova. – 2007. – N 2. – P. 71–75. In Russian
9. Keating, J.F., Simpson, A.H., Robinson, C.M. The management of fractures with bone loss// J Bone Joint Surg. Br. – 2005. – Vol. 87(2). – P.142.
10. De Boer, H.H., Wood, M.B. Bone changes in a vascular fibular graft // Journal of Bone and Joint Surgery. UK . – 1989. – N 71(3). – P. 374–378.
11. De Boer, H.H. Vascularized fibular transfer. Thesis, Leiden. – The Netherlands, 1988.
12. Woo, S.L.Y., Kuei, S.C., Amiel, D. et al. The effect of prolonged physical training on the properties of long bone: a study of Wolff's law // J Bone Joint Surg. – 1981. – Vol. 63-A. – P. 780–787.
13. Jones, H.H., Priest, J.D., Hayes, W.C., Tichenor, C.C., Nagel, D.A. Humeral hypertrophy in response to exercise // J Bone Joint Surg. – 1977. – N 59-A. – P. 204–208.
14 Mizumoto, S., Tamai, S., Goshima, J. et al. Experimental study of vascularized tibiofibular graft in inbred rats: a preliminary report // J Reconstr Microsurg. – 1986. – N 3. – P. 1–9.
15. Bos, K.E, Besselaar, P.P., Eijken, L.W., Raaymakers, E.L.F.B. Failure of hypertrophy in revascularized fibula grafts due to stress protection // Microsurgery. – 1996. – N 17. – P 366–370.
16 Huang, W.C. How does the age factor influence the hypertrophy of vascularized bone grafts? An experimental study // J Nara Med Assoc. – 1988. – N 39. – P 756–772.
17. Lee, K.S., Chung, H.K., Kim, K.H. Vascularized osteocutaneous fibular transfer to the tibia // Int Orthop (SICOT). – 1991. – N 15. – P. 199–203.