Simulated surgery and cutting guides enhance spatial positioning in free fibular mandibular reconstruction

Craig, E. Stirling; Yuhasz, Mikell M.; Shah, Ajul; Blumberg, Jeffrey M.; Salomon, Jeffrey; Lowlicht, Roger A.; Fusi, Stefano; Steinbacher, Derek M.

doi:10.1002/micr.22229

Cited by 63 publications

(38 citation statements)

References 21 publications

(31 reference statements)

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“…Currently, the free fibular flap is the workhorse for mandibular reconstruction, and the indications for free flap reconstructions are similar in pediatric and adult populations . Growth is the main difference between these two populations .…”

Section: Discussionmentioning

confidence: 99%

“…The craniofacial skeleton grows in three dimensions; however, the dynamics, biology, and coordination of this three‐dimensional growth are not clear . Craniofacial skeletal growth occurs in three manners: endochondral growth, suture growth, and appositional and resorptional growth.…”

Section: Discussionmentioning

confidence: 99%

“…The first and the third patterns apply to mandibular growth. Upper and lower facial growth occur via similar mechanisms, and each affects the other …”

Section: Discussionmentioning

confidence: 99%

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The evaluation of flap growth and long‐term results of pediatric mandible reconstructions using free fibular flaps

et al. 2014

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Currently, the free fibular flap is well accepted as the first choice for mandibular reconstruction. Achieving functional results in pediatric patients requires a different approach than that employed for mature patients. Because the pediatric craniofacial skeleton continues to grow, reconstruction is more challenging, and the long-term results can be different from those of adult patients. In this study, we sought to measure flap growth objectively in our series. Ten pediatric patients who underwent reconstruction with free fibular flaps were retrospectively reviewed. Flap growth was evaluated by comparing the intraoperative photographs with photographs of the control panoramic mandibular radiographs taken using photo-anthropometric techniques. The measurements were converted to proportionality indices (PI), and these indices were compared. Subsequent complications and functional results were also evaluated. The mean patient age was 11.8 years, and the mean follow up was 57.7 months. The mean preoperative PI value was 10.74 ± 2.47. The mean postoperative PI value was 12.52 ± 2.34. The mean difference between the preoperative and postoperative PI values was -1.78 ± 0.53. These photo-anthropometric data clearly illustrated the growth of the fibular flaps (P = 0.001). None of these patients exhibited nonunion of the fractures; however, one patient experienced a delayed union, one had chronic temporomandibular joint pain, and one had chronic temporomandibular joint luxation. In two patients, the inter-incisive measurements were below the third percentile, and two additional patients had grade 2 eating abilities, which can be regarded as poor. All of the patients had symmetric mandibular contours. Free fibular flaps continue to grow in pediatric patients. This flap is a "workhorse" flap in children because it adapts to the craniofacial skeleton via its ability to grow, and this ability results in subsequent good cosmetic and functional results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The evaluation of flap growth and long‐term results of pediatric mandible reconstructions using free fibular flaps

et al. 2014

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“…Mandibular reconstruction with an MRP is indicated for elderly patients, patients with poor prognoses, or poor general health, and these patients already have a relatively short life expectancy; therefore, to minimize the number of days of life lost, it is important to achieve secure wound closure and administer adjuvant therapy promptly . Recently, some useful reconstructive procedure has been reported to improve the outcomes for mandibular reconstruction, but an effective procedure for reducing plate‐related complications has not yet been established.…”

Section: Discussionmentioning

confidence: 99%

A “no‐touch‐technique” in mandibular reconstruction with reconstruction plate and free flap transfer

et al. 2015

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“…Since the introduction of free tissue transfer techniques, vascularized bone grafts have been the material of first choice for reconstructing mandibular discontinuity. Mandible reconstruction with vascularized fibular grafts (VFGs) is the favored method because of several advantages, including the availability of long bone segments, tolerance for multiple osteotomies, and a sufficiently thick bony cortex for osseointegrated implants . Several previous studies have examined functional outcomes, but most have not included an analysis of masticatory function based on bite force measurement .…”

mentioning

confidence: 99%

Analysis of functional outcomes in patients with mandible reconstruction using vascularized fibular grafts

et al. 2015

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Simulated surgery and cutting guides enhance spatial positioning in free fibular mandibular reconstruction

Cited by 63 publications

References 21 publications

The evaluation of flap growth and long‐term results of pediatric mandible reconstructions using free fibular flaps

The evaluation of flap growth and long‐term results of pediatric mandible reconstructions using free fibular flaps

A “no‐touch‐technique” in mandibular reconstruction with reconstruction plate and free flap transfer

Analysis of functional outcomes in patients with mandible reconstruction using vascularized fibular grafts

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