Experience with the prefabricated free fibula flap for reconstruction of maxillary and mandibular defects

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
Shahram NazeraniMohammad Hosein Kalantar Motamedi

Abstract

We report our 11-year experience with a new technique to prefabricate the osteocutaneous free fibula flap to reconstruct defects of the maxilla and mandible not amenable to conventional methods of treatment. We treated 11 patients aged 17 to 47 years with jaw defects using prefabricated free fibula grafts from 1994 to 2005. We prepared the fibula on the leg with a 6- to 8-mm muscle cuff; next we transferred the bone flap to the surface of the leg without severing the pedicle, and then covered the muscle almost circumferentially by partial thickness skin graft. The bone flap was left in place with its pedicle intact for 2 to 3 months, after which the skin graft had taken and the flap was free of inflammation. The fibula flap was then transferred to the face, fixed in place with plates, and microvascular anastomosis was performed. Implant placement was completed 4 to 6 months after transfer of the flap to the oral cavity. Graft take was unremarkable in all cases. There were no cases of infection and only minor complications. Edema of the flap may be encountered, which subsides with time. If the mandible is not edentulous the mandibular teeth may bite into the flap, but these wounds heal by the time the patient is ready for implan...Continue Reading

References

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Citations

May 30, 2013·Plastic and Reconstructive Surgery·Shahram Nazerani
May 27, 2009·International Journal of Oral and Maxillofacial Surgery·A GagglF M Chiari
Sep 1, 2015·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Christian BrandtnerAlexander Gaggl
May 11, 2016·Craniomaxillofacial Trauma & Reconstruction·Chingiz R RahimovEmin Hasanov
May 30, 2013·The Journal of Craniofacial Surgery·Emeka NkenkeCornelius von Wilmowsky

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