Muscle Coverage With Fibula Flaps Using Fibrin Glue and a Polyglycolic Acid Sheet: A Six-Patient Case Series

Mandibular defects are usually bridged with a graft that stabilizes the remaining mandibular segments. The aim of this study was to examine the effectiveness of fibular bone graft with the flexor hallucis longus (FHL) muscle and the mucosal defect covered with fibrin glue and polyglycolic acid (MCFP) technique of reconstruction for segmental mandibular defects. Six patients underwent fibular bone grafting with the FHL muscle using the modified MCFP procedure. All wounds in the oral cavity were completely epithelialized 1 to 2 months after surgery. Postsurgical complications occurred in 5 patients: total and partial necrosis of the skin paddle occurred in one patient each, and insufficient wound healing in the neck area occurred in 3 patients. All complications were resolved with debridement, irrigation, and skin grafting or conservative management. All patients demonstrated good masticatory function. This approach resulted in tight, smooth intramural mucosal coverage, which provided stability to the denture without additional preparatory surgeries. Reconstruction using fibular musculature, polyglycolic acid sheets, and fibrin glue may be a useful method in cases of small intraoral defects.