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Mandibular reconstruction with vascularized iliac crest: a 10-year experience
1South Australian Craniofacial Unit, Adelaide Children's Hospital.
Plastic and Reconstructive Surgery
|November 1, 1988
Summary
Vascularized iliac crest bone grafting is a successful method for mandibular reconstruction. This technique has evolved, minimizing complications and tailoring reconstructions for better patient outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Mandibular reconstruction aims to restore form and function after defects.
- The vascularized iliac crest (VIC) flap has been a reconstructive option since 1978.
Observation:
- Surgical techniques for raising and shaping the VIC flap have evolved.
- Early methods used osteocutaneous segments based on superficial or deep circumflex iliac vessels.
- Current techniques utilize the inner ilium, with ulnar forearm free flaps for intraoral lining when needed.
Findings:
- 35 patients underwent mandibular reconstruction using VIC flaps.
- 32 reconstructions were successful, with 3 anastomotic failures.
- One failed segment survived as a free graft; no donor-site complications occurred.
Implications:
- Continuous refinement minimizes operative morbidity and optimizes patient-specific reconstructions.
- Vascularized iliac crest remains a highly effective option for diverse mandibular defects.
- This approach offers a reliable solution for both congenital and acquired mandibular deformities.