Donor site morbidity for free fibula microvascular flaps is generally reported to be low and considered to be minor. We describe a case where the major complication of compartment syndrome occurred in a 15-year-old boy when the donor site defect was closed primarily after taking a skin paddle with a width of 4 cm. We recommend that when harvesting free fibula flaps in children, skin grafting of donor site should be considered irrespective of the width of the flap, if there is any doubt about the tightness of the closure.
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