Vascularized free fibular flap for the reconstruction of mandibular defects: clinical experience in 42 cases

González-García, Raúl; Naval-Gías, Luis; Rodríguez-Campo, F.J.; Muñoz-Guerra, M.F.; Sastre-Pérez, Jesús

doi:10.1016/j.tripleo.2007.04.002

Cited by 77 publications

(51 citation statements)

References 28 publications

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“…From that time various options ranging from alloplastic bone substitutes to free vascularised flaps have been proposed and studied [2]. These defects are often addressed by using vascularised bone flaps and still stand as a gold standard for reconstruction [2][3][4][5][6][7][8][9]. The choice for reconstruction depends on various factors like availability of surgical expertise and equipment, medical fitness of patients and financial factors.…”

Section: Discussionmentioning

confidence: 99%

“…Reconstruction options for mandible range from metallic reconstruction plate to vascularised bone flaps [3][4][5][6][7][8][9][10]. Non vascular bone grafts could be used judiciously for reconstruction of selective mandibular defects with not much of soft tissue loss provided the defect is \9 cm [11], stable fixation to the native mandible and a 2-layer watertight closure both intraorally and extraorally.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Non-vascular Fibula Graft for Mandibular Reconstruction

Devireddy

Murugan

Kumar

et al. 2014

J. Maxillofac. Oral Surg.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Non-vascular Fibula Graft for Mandibular Reconstruction

Devireddy

Murugan

Kumar

et al. 2014

J. Maxillofac. Oral Surg.

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“…Hence, multiple osteotomies of the fibula to confirm to the maxilla and mandible are feasible without devascularising individual segments. Moreover FFF offers tremendous bicortical bone stock for dental implant placement and a versatile cutaneous unit for concomitant soft tissue reconstruction [2][3][4][5][6][7][8][9]. Also FFF based on separate septocutaneous perforators is of benefit to extensive substitution to externally cutaneous and internally oral linings [10].…”

Section: Introductionmentioning

confidence: 99%

Versatility of Fibula Free Flap in Reconstruction of Facial Defects: A Center Study

Shroff

Nair

Shah

et al. 2016

J. Maxillofac. Oral Surg.

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Purpose To study a series of cases where vascularised fibula flap was used in various combinations of bone with muscle and skin along with its modifications for reconstruction of simple and composite defects of the facial region. Patients and MethodsThe investigators designed a retrospective study composed of patients with any pathology or defect who underwent reconstruction of maxilla or mandible with vascularised fibula free flap from 2009 to 2013. All patients were evaluated for age, gender, location and type of defect, incorporation of adjoining skin paddle and muscle, number of fibula osteotomies, ischaemia time, anticoagulant regimen, length of hospital stay, flap failure rate, dental implant rehabilitation. All patients with a minimum follow-up of 3 months post-operatively, were included in this study. Results The study sample composed of 30 patients with average age of 39.5 years. Immediate reconstruction was done in 86.66 % of patients. 93.1 % were mandibular reconstructions. In 40 % of patients, the fibula was double barrelled. Skin island was included with the fibula in 20 % of patients. 10 % patients underwent dental rehabilitation using implants with 6.66 % requiring distraction osteogenesis of the fibula which was not required with double barrel reconstructions. Hematoma at the recipient site was the commonest post-operative complication, although its frequency was low. A significant donor site morbidity of around 3.33 % was seen. Average stay in hospital was about 7 days. Post-operatively all patients ambulated normally and none used assisted devices. A reconstruction plate was used to achieve the ideal contour of the jaw in most cases. Aesthetic results were usually good, especially in young patients. The overall success rate was 93.33 %. Conclusion The fibula has many assets which make it the ideal choice for bony reconstruction of facial skeleton and adjoining soft tissue with predictable results.

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“…Primary reconstruction of composite mandibular defects with a free fibula osteoseptocutaneous flap is a technique that provides good cosmetic and functional results [1][2][3][4]. The straight fibula flap has to be osteotomised and a correct size of the angle between the segments and the length of the segments is critical.…”

Section: Introductionmentioning

confidence: 99%

A computer-based comparative quantitative analysis of surgical outcome of mandibular reconstructions with free fibula microvascular flaps

Leiggener

Król

Gawelin

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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The free fibula osteoseptocutaneous flap is the standard for reconstruction of extensive mandibular defects. The procedure must be precise to achieve the required functional and aesthetic results. The aim of the present study was to calculate retrospectively the exact differences in surgical outcome based on preoperative and postoperative Computed Tomography data sets. Ten patients with unilateral reconstructions of the mandible with a fibula based on conventional planning were analyzed quantitatively, applying mirroring techniques with direct comparison of the theoretically optimum with the actual reconstruction. The results showed that there is a significant discrepancy between what is actually achieved and the theoretical optimum. The result of the present retrospective analysis shows that there is room for further improvement of the outcome in complex mandible reconstruction cases.

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Vascularized free fibular flap for the reconstruction of mandibular defects: clinical experience in 42 cases

Cited by 77 publications

References 28 publications

Evaluation of Non-vascular Fibula Graft for Mandibular Reconstruction

Evaluation of Non-vascular Fibula Graft for Mandibular Reconstruction

Versatility of Fibula Free Flap in Reconstruction of Facial Defects: A Center Study

A computer-based comparative quantitative analysis of surgical outcome of mandibular reconstructions with free fibula microvascular flaps

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