Background: Mandibular defects may result from trauma, infections, cancer ablation or radiation necrosis. These defects may vary according to the content and nature of the tissues that require reconstruction. The objective of this study was to evaluate the outcome of vascularised free fibula flap for mandibular reconstruction in terms of flap success rate and complications.Material and Methods: This prospective clinical study was carried out at Department of Plastic Surgery, Hayatabad Medical Complex, Peshawar from January 2014 to December 2018. The study included patients of either gender who underwent mandibular reconstruction with free fibula oseteocutaneous flap during the study period. Diabetic patients with underlying vascular pathologies and cachectic patients were excluded from the study.Results: There were 56 patients with 38 males and 18 females. Their age ranged from 24-66 years with a mean age of 36 years. The mandibular defects resulted from various etiologies and included: Squamous cell carcinoma (n=27, 48.21%), Giant cell granuloma (n=3; 5.35%), Ameloblastoma (n=2; 3.57%), Road traffic accidents (n=10; 17.85%), Firearm injury (n=9; 16%), Bomb blast injury (n=3; 5.35%) and osteoradionecrosis (n=2; 3.57%). Primary reconstruction of the mandibular defects was performed in 44 patients, whereas delayed reconstruction was performed in 12 patients. Out of the 56 flaps, 49 flaps survived completely. Our share of complications was as follows: Wound infections (n=13; 23.21%), Skin graft loss at donor site (n=5; 8.95%), Complete flap loss (n=4; 7.14%), Orocutaneous fistulae (n=3; 5.35%), Ankle instability (n=2; 3.57%), Skin paddle necrosis (n=1; 1.78%) and sensory deficit distal to donor site (n=1; 1.78%).Conclusions: Microvascular free fibula is a reliable tool for mandibular reconstruction following tumor resection or trauma. The flap has a high success rate and relatively fewer complications.
What do literacy events look and feel like for doctoral students, and how do these events overlap intertextually, materially and relationally? The last three decades have seen a rapid diversification in doctoral education where new opportunities for study, combined with an increasingly competitive landscape, have disrupted what it means to undertake a doctorate, as well as reshaping the literacy practices that comprise doctoral experiences in new ways that have not been fully explored. To understand literacies in new ways, we put to work the construct of literacy‐as‐event, and engage ideas from assemblage theory, to theorise the relationality of literacy practices. Crucially, our study seeks to examine how literacies are emergent and entangled within a wider network of relations. This article draws on data from interviews involving critical incidents with 12 doctoral students, in order to unpack the literacy moments, beyond the thesis, that comprise students' experiences. Our data suggest that we can understand doctoral literacies, not as bounded occurrences, but as assemblages of practices. We contend that thinking with concepts of assemblage and of event offers new insights into the evolving experiences of doctoral students, as well as offering an enriched understanding of literacies and literacy research.
This research study was conducted to explore the grade retention practices in private schools of Karachi. The study focused on the impact of grade retention and investigated its effectiveness in terms of its merits versus demerits. The context of the study was six private schools of Karachi and scorecards of the failed students from the selected schools, who were in grade six, seven and eight. To achieve the objectives of the study, a mixed method was undertaken to collect the data. The quantitative data were derived from the scorecards of 84 students of two years, summing to a total of 168 scorecards of 84 failed students, who repeated the class in the same school. Paired sample t-test, one sample t-test and two-way MANOVA were applied to analyze the data. The researcher conducted interviews of six teachers and three principals. The interviews were transcribed and decoded, followed by categorization to explore the themes that emerged. The most crucial finding of the research is that retention and social promotion are ineffective solutions for the struggling learners.
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