Functional assessment of donor‐site morbidity after harvest of a fibula chimeric flap with a sheet of soleus muscle for mandibular composite defect reconstruction

Abstract

This study aims to compare donor-site morbidity between the traditional fibula osteocutaneous and chimeric fibula flaps for mandibular reconstruction. Twenty-three patients with head and neck cancer were recruited. Fifteen patients underwent the traditional fibula osteocutaneous flap. Eight patients received a chimeric fibula osteocutaneous flap with a sheet of soleus muscle. Subjective donor-site morbidities were evaluated by questionnaire. Objective isokinetic testing and 6-minute walking test (6MWT) were used to evaluate ankle strength and walking ability. The results revealed no significant difference was found in total average score of the questionnaire between the traditional (2.57) and the chimeric (2.75) groups (P> 0.05). There were no significant differences in peak torque/total work of ankle motions and in walking ability at 6MWT between the traditional and chimeric groups (P > 0.05). In conclusion, compared with the traditional fibula osteocutaneous flap, the chimeric fibula flap does not increase donor-site morbidity for reconstructive surgery.

Prospective series of reconstruction of complex composite mandibulectomy defects with double island free fibula flap

“…Overall, the donor site complications were no different than what has previously been reported in the literature. 17,18 However, the use of a single free fibula flap from a single donor site minimizes the morbidity of an additional donor site, if a second free flap is used or the use of a pectoralis major flap with its associated deformity and sequelae.…”

Modified surgical techniques of free vascularized fibular grafting for treatment of the osteonecrosis of femoral head: Results from a series of 407 cases

“…The harvest of the free vascularized fibula through the lateral approach and osteotomy prior to the dissection of vascular pedicle was found to simplify the procedure . Although different experiences on the harvest of the free vascularized fibula graft have been described, our experience showed that the postoperative complications by our technique were rarely seen . The time for harvest of the vascularized fibula graft could be shortened to 10–15 min .…”

A modified free chimeric osteocutaneous fibular flap design for head and neck reconstruction: Experience on a series of 10 cases

“…In the 10 cases, we preferred harvesting the modified fibular flap from the left leg because we believe that the right leg is more important than the left for driving a vehicle. Donor site morbidity after harvesting free fibular flap was discussed in review literatures . Little morbidity was reported even after harvesting hemisolues muscle for reconstruction.…”

“…In such instance, it would be very difficult for the flap to be adhesive to the residual tissue and causing a space for seroma accumulation. Several literatures reported harvesting a trip of soleus muscle during fibular flap harvest to augment the submandibular region and to obliterate the space produced by bone stenting across the mandible defect . Therefore, it was believed that we might be able to overcome these unacceptable results by insetting a strip of soleus muscle to the submandibular region to obliterate the dead space and augment the sunken cheek to gain better reconstruction result.…”