Titanium miniplate fixation in free flap mandible reconstruction

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Biomaterials Engineering

Background:

• Mandible reconstruction presents challenges in achieving stable fixation and optimal aesthetic results.
• Free flap reconstruction is a common method for large mandibular defects.
• Traditional fixation methods may have limitations in terms of application time and graft contouring.

Purpose of the Study:

• To evaluate the efficacy and safety of titanium miniplate fixation in free flap mandible reconstruction.
• To assess the impact of miniplate fixation on flap survival, bone healing, and aesthetic outcomes.
• To identify potential complications and advantages associated with this fixation technique.

Main Methods:

• A retrospective review of 27 patients undergoing free flap mandible reconstruction using titanium miniplates.
• Analysis of flap donor sites (radius, scapula, fibula) and bone defect sizes (5-16 cm).
• Documentation of the number of fixation sites, miniplates used, and follow-up for complications such as nonunion and wound healing issues.

Main Results:

• All free flaps survived, with no critical compromise to flap circulation from plate pressure or screw placement.
• A low nonunion rate of 2 out of 107 osteotomy sites was observed.
• Four patients experienced wound healing problems requiring plate removal, with plates retained until complete bone healing.

Conclusions:

• Titanium miniplates provide a stable and effective fixation method for free flap mandible reconstruction.
• The technique offers advantages including ease of application, reduced fixation time, and precise graft contouring for superior aesthetic results.
• Intermaxillary fixation was not required, indicating sufficient stability with miniplate use alone.