Long-term follow-up with mention of complications in pediatric microvascular mandibular reconstruction

The fibular free flap has become the gold standard for mandibular reconstruction. Despite its vast array of benefits, this procedure has the potential for several complications. In the pediatric setting, the immature skeleton sets the stage for an increased risk of future skeletal abnormalities, both in the jaw, and in the donor site. Herein we describe the case of a toddler who underwent mandibular reconstruction using a fibula free flap and, years later, subsequently developed ankle instability as a result of residual fibula migration. This indicates the need for careful consideration of long-term issues in the growing pediatric skeleton prior to surgery.