Abstract
INTRODUCTION: Gunshot injuries to the foot can result in complex composite defects requiring comprehensive reconstructive strategies to restore both bony architecture and soft-tissue integrity. These injuries pose significant challenges due to extensive tissue destruction and the need for vascularized bone transfer. CASE REPORT: In this study, we present two cases of foot reconstruction using customized osteocutaneous vascularized fibular flaps following shotgun and rifle injuries, and we compare our approach with existing literature. Despite considerable soft-tissue loss, the primary arterial supply to the foot was preserved, allowing for successful microsurgical reconstruction. Our staged strategy, combining external fixation with vascularized fibular transfer, achieved favorable structural and functional outcomes. CONCLUSION: These cases support the feasibility of using vascularized fibular flaps in severe foot trauma and emphasize the importance of meticulous surgical planning to optimize results.