Summary:The free vascularized fibula flap has been widely used for clavicle reconstruction. Limited evidence exists for the long-term outcome of clavicle reconstruction using the free vascularized fibula flap in adults. We report the functional and aesthetic outcome in a 52-year old man a decade after clavicle reconstruction using a free vascularized fibula flap in combination with a modified Richardson Hook Plate. At the 10-year follow-up, panoramic shoulder X-ray showed the modified Richardson Hook Plate had remained firmly in place with the fibula and the hook positioned beneath the acromion. Functionally, the patient presented with a constant shoulder score of 77, with a pain-free symmetrical full range of motion. In conclusion, reconstruction of lateral clavicle defect using free vascularized fibula flap in conjunction with modified Richardson Hook plate may provide patients with excellent long-term functional and aesthetic outcomes.

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