Union and Bone Resorption of Free Fibular Flaps in Mandibular Reconstruction

Abstract

Background The purpose of this study was to evaluate bony union and resorption after free fibular flap reconstruction for mandibular reconstruction.

Methods A total of 112 patients with composite resection and reconstruction with a fibular free flap were included. Computed tomography scan images taken after the reconstruction and approximately 1 year postoperatively were assessed to evaluate union (n = 60) and bone resorption (n = 24) of the neomandible.

Results Most of the fibulas healed well (n = 34) and there was radiologic nonunion in 20% of the neomandibles at the time of evaluation (mean = 15 months). There was a statistically significant reduction in bone height in the native mandible (p = 0.02) and the anterior part of the fibular graft (p = 0.02).

Conclusions There was a statistically significant reduction in mandibular and fibular graft height. However, the bone resorption was clinically minimal. Sufficient maintenance of height and good bony union support the use of free fibular flap in mandibular reconstruction.

Keywords

mandible reconstruction - fibula - free flap - bone union - resorption

Note

This study was presented at the Annual Meeting of American Society for Reconstructive Microsurgery in Cancun, Mexico in January, 2011 and at the Congress of the World Society for Reconstructive Microsurgery in Helsinki, Finland in June 2011.

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