The vascularized fibula graft in mandibular reconstruction

Functional Outcomes of Virtually Planned Free Fibula Flap Reconstruction of the Mandible

“…1,7,8 This modality has been the subject of intense study and has in a relatively short period become the criterion standard for reconstruction of complex mandibular defects. Advocated indications for use of this flap include defects crossing the symphysis, large bony defects, composite defects, previous reconstructive failure, and recipient beds requiring vascularized tissue.…”

Biomechanical loading test on reconstructed mandibles with fibular, iliac crest or scapula graft: a comparative study

“…Hidalgo first reconstructed a mandible using a fibular free flap in1989, 3 since when its suitability (particularly for extensive bony defects over half the size of the mandible) has been confirmed. [4][5][6] Up to two skin paddles can be taken in addition to the segment of bone, which allows simultaneous closure of soft tissue defects. 3,4,6 However, in some cases, such as segmental mandibulectomy or hemimandibulectomy, the iliac crest flap with the deep circumflex iliac artery (DCIA) as its vascular pedicle is thought to be superior to the fibular flap, as its natural curvature better mimics the shape of the mandible, and it sometimes even supersedes the need for osteotomy.…”

A Simple and Cost Effective Template for Central Segment Reconstruction of Mandible with Free Fibula Flap

“…The advantages of using templates are well supported by Hidalgo [3] and Strackee [6]. These templates are made preoperatively from routine X-rays [7], orthopantomograms [8], three dimensional CT scan [9], acrylic jaw impressions [10] and lateral cephalogram [11]. Intra operatively, the templates can be made from the resected specimen [12], reconstruction plate [13], tongue blade template [14], aquaplast [15] template, by jigsaw [16] technique or by preplating systems [17].…”