Fibula free flap splitting for mandible reconstruction: A technical note

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic and Reconstructive Surgery
• Biomaterials Engineering

Background:

• Mandibular reconstruction presents challenges in achieving optimal fit and function.
• Fibula free flaps are a common choice for mandibular reconstruction, but flap adaptation can be difficult.
• Existing osteosynthesis methods may require significant hardware, increasing complexity and potential complications.

Purpose of the Study:

• To review the axial splitting technique for fibula free flaps in mandibular reconstruction.
• To present a novel method of osteosynthesis for improved flap adaptation and fixation.
• To evaluate the effectiveness of this technique in achieving adequate mandibular angle shape with minimal hardware.

Main Methods:

• Review of the 'axial splitting' technique for fibula free flaps.
• Description of a novel osteosynthesis approach for flap insetting.
• Surgical technique focusing on osteotomy at the mandibular angle for precise contouring.

Main Results:

• The axial splitting technique facilitates better conformation of the fibula flap to the mandible.
• The novel osteosynthesis method allows for secure fixation with reduced titanium hardware usage.
• Adequate mandibular angle shape was achieved, improving aesthetic and functional outcomes.

Conclusions:

• The axial splitting technique, combined with the novel osteosynthesis method, offers an effective solution for challenging fibula flap reconstructions of the mandible.
• This approach minimizes hardware requirements, potentially reducing complications and improving patient outcomes.
• Further research should validate these findings in larger clinical studies.