Feasibility of the vascularized fibula bone graft for reconstruction of the mandible: a cadaveric study

Vittayakittipong, P.; Jarudejkajon, J.; Kirirat, Pornpimol; Chaijaroonkhanarak, Wunnee; Chaisiwamongkol, Kowit

doi:10.1016/j.ijom.2015.11.016

Cited by 9 publications

(9 citation statements)

References 10 publications

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“…The limitation of the length of vascularized auto-bone grafts is from 14 to 24 cm, even if it is a vascularized fibula graft. 25 The use of a vascularized fibula graft is valuable in the treatment of long bone defects. Yet, stress fractures are frequently observed during the first postoperative year when a sole fibula is used for such a long bone defect because the vascularized bone graft is still weak and unable to bear full weight.…”

Section: Discussionmentioning

confidence: 99%

“…However, the limitation of the graft length was only 12 cm because the maximum length of fibular graft that we can harvest is 24 cm. 25 Moreover, the 24-cm-long harvest of fibula can induce other complications at the donor site, such as ankle joint instability. In any case, these methods have a major problem due to the loss of normal bone tissues.…”

Section: Discussionmentioning

confidence: 99%

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Prefabrication of Vascularized Allogenic Bone Graft in a Rat by Implanting a Flow-Through Vascular Pedicle and Basic Fibroblast Growth Factor Containing Hydroxyapatite/Collagen Composite

Yamaguchi

Kaji

Nakamura

et al. 2017

J reconstr Microsurg

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Basic fibroblast growth factor (bFGF) is known to stimulate bone formation and angiogenesis. Hydroxyapatite/collagen composite (HAp/Col) is also known to have very strong bone conductive activity. In this study, prefabrication of vascularized allogenic bone (allo-bone) graft was attempted in recipients by implanting vascular bundles from recipients into the transplanted allo-bone graft. Furthermore, the effect of bFGF-containing HAp/Col on the prefabricated vascularized allo-bone graft was investigated. In this study, 32 Sprague-Dawley rats were used as donors, and bone grafts were collected from their femora. Thirty-two Wistar rats (recipients) were divided into four groups, and the allo-bone grafts were transplanted into the thigh region. In the experimental groups, one or both of the flow-through saphenous vascular bundles and 100-μg bFGF-containing HAp/Col were implanted into the medullary cavity of the allo-bone grafts. In the control group, neither was implanted. These rats were sacrificed at 4 weeks after transplantation, and boneformation, angiogenesis, and bone resorption in the transplanted allo-bone grafts were evaluated histologically and genetically. Bone formation and angiogenesis in the transplanted allo-bone graft were effectively stimulated by implanting vascular bundles or bFGF-containing HAp/Col on both histological and genetic evaluations compared with the control group. The most significant stimulation was observed in the group in which both were implanted. Bone resorption was not stimulated in any group. By implanting a flow-through vascular bundle and bFGF-containing HAp/Col, an ideal vascularized allo-bone graft that had high bone formative and angiogenetic activities and did not stimulate bone resorptive activity was prefabricated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prefabrication of Vascularized Allogenic Bone Graft in a Rat by Implanting a Flow-Through Vascular Pedicle and Basic Fibroblast Growth Factor Containing Hydroxyapatite/Collagen Composite

Yamaguchi

Kaji

Nakamura

et al. 2017

J reconstr Microsurg

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“…The type of bone flap was determined according to the length of the defect area, and the bearing capacity of the bone flap. 2,3 Then we imported the data of the donor site, and designed the repair plan according to the shape of the reference data model, taking into account the occlusal distance, and utilizing the design file and the stereolithography (STL) model (Fig. 1A and B).…”

Section: Preoperative Virtual Designmentioning

confidence: 99%

Accurate Reconstruction of Mandibular Defects With Vascularized Bone Flaps Through Utilization of Mandible Space-Retention Guides

Wang¹,

Zeng

Jie³

et al. 2022

Journal of Craniofacial Surgery

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Comprehensive evaluation of the effects of using computer-aided design and space retention guide technology to reconstruct mandibular defects using vascularized autogenous bone flaps. Method: This study included 8 patients who received autogenous bone flaps (2 cases of vascularized fibula flaps and 6 cases of vascularized iliac flaps) for mandibular defect reconstruction at Peking University School and Hospital of Stomatology, from July 2018 to May 2021. All patients received digital surgery planning, computer aided design/computer aided manufacture, surgical guide technique for the removal of diseased bone segments, as well as vascularized fibular flap/iliac flap reconstruction. Three-dimensional deviations were analyzed after the operation. Result: The mandibular defects of all 8 patients were successfully reconstructed using the vascularized fibular flap/iliac bone flap. There were no serious complications at either the donor site or recipient site during our follow-up. The average threedimensional deviation of all 8 patients was 1.92 mm, based on comparisons of preoperative design and actual postoperative computed tomography. Conclusion: Utilizing computer aided design/computer aided manufacture, we designed a new mandibular space-retention guide, which can accurately translate the preoperative digital design plan to real-time surgery with satisfactory accuracy and efficacy.

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“…Leading options for microvascular osseous reconstructions include bare bone flaps (BBFs) and osteocutaneous flaps (OCFs). Bone flaps are vascularized segments of bare bone harvested from the fibula, scapula, or iliac crest (Cordeiro, Henderson, & Matros, 2018; Gennaro et al, 2014; Kokosis, Schmitz, Powers, & Erdmann, 2016; Okcu & Rustemeyer, 2018; Sarukawa et al, 2012; Schimming, Juengling, Lauer, & Schmelzeisen, 2000; Uǧurlu et al, 2007; Vittayakittipong, Jarudejkajon, Kirirat, Chaijaroonkhanarak, & Chaisiwamongkol, 2016). These bone flaps are particularly advantageous for the restoration of non‐composite osseous resections (Cordeiro et al, 2018; Kokosis et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of microvascular bone flaps versus osteocutaneous flaps in head and neck reconstruction

et al. 2020

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Background: Surgical resection of head and neck (H&N) neoplasms requiring osseous reconstruction have underdefined complication profiles. This study aimed to characterize postoperative outcomes of patients with H&N neoplasia undergoing osteocutaneous flap (OCF) or bare bone flap (BBF) reconstructions. Materials and methods: Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) 2005-2017 databases. Queried for diagnosis and procedural codes extracted patients with H&N neoplasms undergoing BBF or OCF reconstruction. Postoperative complications were evaluated. Multivariable regression generated adjusted odds ratios. Results: A cohort of 746 patients were identified. Of reconstructions, 24.9% (n = 186/746) were BBFs while 75.1% (n = 560/746) were OCFs. 58.1% of the BBF cohort and 59.9% of the OCF cohort experienced an all-cause complication (p = .654). Sub-stratified, 24.2% of BBF and 17.5% of OCF patients experienced a wound complication (p = .045). Regression analysis demonstrated no difference in risk for medical complications between cohorts. However, patients receiving OCFs had a decreased likelihood of developing a wound complication (OR 0.652; 95%CI 0.430-0.989; p = .044) compared to patients receiving BBFs. Conclusion: The incidence of complications following osseous reconstruction of the H&N is considerable. Although several complication outcomes do not seem to differ between BBF or OCF reconstructions, OCFs is associated with a decreased likelihood of wound complications. 1 | INTRODUCTION Benign and malignant neoplasms of the head and neck (H&N) exert significant global morbidity with H&N cancer occurring in more than 500,000 patients across the globe each year (Jemal et al., 2011). An estimated 65,000 of these new cases are annually diagnosed in the United States, of which 14,000 result in death (Cancer.net Editorial Board, n.d.). These statistics are further magnified by cutaneous malignancies localized to the H&N (Mydlarz, Weber, & Kupferman, 2015). Ultimately, the treatment of H&N neoplasms is multi-faceted and interdisciplinary involving medical, surgical, occupational, and psychological support (Wheless, McKinney, & Zanation, 2010). Surgical intervention is an integral aspect of H&N tumor management with excision dependent upon tumor location and characteristics (Carlson & McCoy, 2017; Fu, Foreman, Goldstein, & de Disclaimer: The ACS NSQIP databases are the source of information used in this study. Data extrapolated, statistical analysis performed, and conclusions reached have not been verified by the ACS NSQIP but rather are the result of the work done by authors of this study.

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Feasibility of the vascularized fibula bone graft for reconstruction of the mandible: a cadaveric study

Cited by 9 publications

References 10 publications

Prefabrication of Vascularized Allogenic Bone Graft in a Rat by Implanting a Flow-Through Vascular Pedicle and Basic Fibroblast Growth Factor Containing Hydroxyapatite/Collagen Composite

Prefabrication of Vascularized Allogenic Bone Graft in a Rat by Implanting a Flow-Through Vascular Pedicle and Basic Fibroblast Growth Factor Containing Hydroxyapatite/Collagen Composite

Accurate Reconstruction of Mandibular Defects With Vascularized Bone Flaps Through Utilization of Mandible Space-Retention Guides

Outcomes of microvascular bone flaps versus osteocutaneous flaps in head and neck reconstruction

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