McCune-Albright syndrome is a genetic disease, defined by a clinical triad of polyostotic fibrous dysplasia of bone, café-au-lait skin spots, and precocious puberty. The case of a young man with McCune-Albright syndrome and fibrous dysplasia resulting in a severe tibial deformity is presented.

Due to previous surgeries as a child, and subsequent complications with ongoing infection and soft tissue breakdown, the patient was keen to seek any reconstructive option with a chance of limb salvage.

Multilevel, corrective tibial osteotomies were carried out by the orthopaedic team, followed by an acute deformity correction of the tibia, stabilised with an intramedullary tibial nail. This was followed by a soft tissue debridement and anterolateral thigh free flap by the plastic surgical team to cover the previously infected and broken down soft tissue over the anterior aspect of the tibia. The 10 hour surgery was completed without complication.

A combined multidisciplinary approach to this rare disease and associated severe deformity has demonstrated an excellent outcome at one year with complete healing of the tibia. The patient is fully mobile and is pain free.