Fibula osteoseptocutaneous free flap in maxillary reconstruction

Abstract

The skin paddle in the fibula osteoseptocutaneous flap is thin, soft, and pliable, and it can be used for external skin coverage and intraoral linings. The flexibility of the fibula in three-dimensional positioning after multiple osteotomies is desirable in complex spatial skeletal reconstruction. The fibula osteoseptocutaneous flap is suitable for one-stage reconstruction of composite maxillary defects. The unique characteristics of the fibula osteoseptocutaneous flap and its application in the one-stage composite maxillary defect are discussed.

Aesthetic Microvascular Periorbital Subunit Reconstruction

“…The fibula osteocutaneous flap can be osteotomized multiple times to restore the buttresses and threedimensional periorbital aesthetics. 11,21 The flap has a long pedicle and a reliable skin paddle, which are necessary for reconstructing most of Volume 131, Number 2 • Microvascular Periorbital Reconstruction these defects. The fibula flap is usually associated with minimal donor-site morbidity and can be closed primarily when smaller skin paddles are used.…”

Maxillary reconstruction using anterolateral thigh flap and bone grafts

“…11 The use of bone-containing free flaps 12 represents our first choice for many patients, especially when the resection involves more than half of the alveolar crest and when the patient is motivated to undergo dental rehabilitation with endo-osseous implants. 13 These techniques allow good and stable long-term results, but also present some disadvantages, in that they require longer perioperative times and flap insetting is not easy, with short pedicles that often require venous grafts (iliac crest).…”

Reconstruction of the midface and maxilla

“…A variety of donor sites providing soft tissue only or soft tissue with bone have been described in the literature, including the radial forearm [14][15][16][17][18], rectus abdominis [19,20], fibula [21][22][23][24], scapular [25][26][27], iliac crest [28,29], and anterolateral thigh [30,31] systems of free flaps. In all cases of midfacial reconstruction, the individual characteristics of the defect and the patient will guide which type of reconstruction is undertaken.…”