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Backgrounds: The free fibula osteocutaneous flap is a reliable choice for reconstruction of composite maxillary defects.However, its skin paddle has a number of problems that include its bulk, hair-bearing surface, difficulty in insetting the graft, potential need for skin graft at the donor site, and potential variation of skin perforators.The fibula-flexor hallucis longus myofascial flap (FFHLMF flap) is a modification of the fibula osteocutaneous flap that overcomes these drawbacks.