Approach for Mandibular Reconstruction Using Vascularized Free Fibula Flap: A Review of the Literature

Fatani, Bader; Fatani, Jumana A; Fatani, Omar A

doi:10.7759/cureus.30161

Cited by 14 publications

(14 citation statements)

References 20 publications

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“…The cross-sectional area of the fibula graft is significantly smaller than that of the femur, making it more prone to complications of stress fractures when subjected to weight-bearing. When the graft is used in two parts with the preservation of a vascular pedicle, it can overcome this problem and also provide structural support by increasing vascularity [25][26][27][28]. The double-barreled fibular flap is recommended for femur and proximal tibia reconstruction when the defect size is less than 13 cm [29].…”

Section: Discussionmentioning

confidence: 99%

The Use of Free Fibula Flap in Different Extremities and Our Clinical Results

Atilgan

2023

Cureus

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Background and objectives Plastic, orthopedic, otolaryngology, and oromaxillofacial surgery specialists rely on fibula grafts to solve reconstructive problems. The aim of this study is to discuss the use and results of vascular fibula flaps in the treatment of bone and soft tissue defects in various regions with different etiologies. Materials and methods In our clinic, we treated 32 patients with osteocutaneous fibular flaps due to bone and soft tissue defects of different etiologies and varying anatomical regions. In our study, age, gender, side, cause of injury, surgical technique, treatment results, and complications were evaluated for each patient. Results Of the 32 patients, 25 were male, and 7 were female. The average age is 37.2 (27-56). The mean bone defect size was 10.45 cm. Bone defect occurred in eight patients due to osteomyelitis, eleven patients due to gunshot wounds, nine patients due to pseudoarthrosis, and four patients due to a giant cell tumor. We applied osteocutaneous fibula flap in 27 patients and vascularized fibular flap in five patients. Bone union could not be achieved in four patients, and bone grafting was performed as a secondary surgery. Local infection occurred in five patients, and their treatment was completed with debridement and antibiotic administration. Wound complications occurred in three patients at the donor site, which were treated with debridement and skin grafting. The mean duration of radiological union was three months, and complete union was achieved in the seventh month. Conclusions We have shown in our case series that free vascularized fibula transfer has gained an important place in the field of skeletal reconstruction and is a reliable method for various bone reconstructions.

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Section: Discussionmentioning

confidence: 99%

The Use of Free Fibula Flap in Different Extremities and Our Clinical Results

Atilgan

2023

Cureus

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“…Mandibular resection might be needed in various diseases, such as osteoradionecrosis, trauma, and cancer. Over the years, the free fibula flap (FFF) has become the preferred choice and gold standard for mandibular reconstruction [ 1 , 2 ]. The primary goal of mandibular reconstruction is to achieve satisfactory morphology and function.…”

Section: Introductionmentioning

confidence: 99%

Comparison of condylar position after free fibular flap mandibular reconstruction using computer-assisted and traditional techniques

Wang,

Li,

Liao

et al. 2024

BMC Oral Health

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Objectives To compare the changes in condylar position after mandibular reconstruction with free fibular flap(FFF) and the differences between computer-assisted techniques and traditional methods on CT images. Methods Thirty-four patients who underwent mandibular reconstruction with free fibular flap were selected according to the inclusion and exclusion criteria. In the 3D group, virtual surgical planning (VSP) with osteotomy cutting plate and placement guiding plate were used, while the traditional group underwent freehand reconstruction. The CT data of 68 temporomandibular joints (TMJs) were recorded before and immediately after surgery. The condylar position was evaluated by measuring the anterior space (AS), posterior space (PS) and superior space (SS), and the ln (PS/AS) was calculated according to the method proposed by Pullinger and Hollender. Results In the patients included in the 3D group, the condyle on the ipsilateral side moved slightly backward; however, in the patients in the traditional group, the ipsilateral side moved considerably anteroinferior. No obvious changes on the contralateral side were noted. In the 3D group, 33% of ipsilateral condyles were in the posterior position postoperatively when compared with the preoperative position (13%). In the traditional group, the number of ipsilateral condyles in the anterior position increased from 4 to 10, accounting for 53% postoperatively. Contrary to the traditional group, the 3D group presented less condylar displacement on the ipsilateral side postoperatively. Conclusions This study showed a decreased percentage of change in condylar position postoperatively when VSP was used. Virtual surgical planning improved the accuracy of FFF mandibular reconstruction and made the condylar position more stable.

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“…Mandible resections, often necessitated by trauma, tumors, or congenital deformities, present intricate challenges due to their vital role in facial aesthetics and function [1]. The subsequent reconstruction process frequently relies on autologous grafts, which offer optimal biocompatibility and minimized rejection risks [2].…”

Section: Introductionmentioning

confidence: 99%

Digital Implant-Supported Restoration Planning Placed in Autologous Graft Using Titanium Implants Produced by Additive Manufacturing

Louro,

Moraschini,

Melhem-Elias

et al. 2024

Dentistry Journal

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This clinical report presents a technique to reconstruct extensively resected mandibles using a combination of autologous bone grafts and additive manufacturing techniques. Mandibular defects, often arising from trauma, tumors, or congenital anomalies, can severely impact both function and aesthetics. Conventional reconstruction methods have their limitations, often resulting in suboptimal outcomes. In these reports, we detail clinical cases where patients with different mandibular defects underwent reconstructive surgery. In each instance, autologous grafts were harvested to ensure the restoration of native bone tissue, while advanced virtual planning techniques were employed for precise graft design and dental implant placement. The patients experienced substantial improvements in masticatory function, speech, and facial aesthetics. Utilizing autologous grafts minimized the risk of rejection and complications associated with foreign materials. The integration of virtual planning precision allowed customized solutions, reducing surgical duration and optimizing implant positioning. These 2 cases underscores the potential of combining autologous grafts with virtual planning precision and dental implants produced by additive manufacturing for mandible reconstruction.

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Approach for Mandibular Reconstruction Using Vascularized Free Fibula Flap: A Review of the Literature

Cited by 14 publications

References 20 publications

The Use of Free Fibula Flap in Different Extremities and Our Clinical Results

The Use of Free Fibula Flap in Different Extremities and Our Clinical Results

Comparison of condylar position after free fibular flap mandibular reconstruction using computer-assisted and traditional techniques

Digital Implant-Supported Restoration Planning Placed in Autologous Graft Using Titanium Implants Produced by Additive Manufacturing

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