Angle-to-angle mandibular reconstruction with two free fibular flaps in a patient with two consecutive gingival...

Two consecutive mandibular reconstructions with free vascularised fibular grafts in a patient with gingival cancers are presented. After resection of a gingival cancer on the left side, reconstruction was performed with a free vascularised fibular graft from the left leg. Two-and-a-half years later, a second free vascularised osteoseptocutaneous fibular graft from the right leg was used to reconstruct the right mandible and floor of the mouth after resection of a new gingival cancer. The two flaps have reconstructed the mandible from angle-to-angle. During the second reconstruction, a deviation of the left neomandible to the right side was corrected. Both postoperative courses were uneventful. Donor site morbidity was negligible, and the osteosyntheses healed well. This result further emphasises the value of the free fibular flap and the importance of adequate contouring of the fibular graft with osteotomies.