Mandibular reconstruction with free vascularized fibular flap

Area of Science:

• Plastic Surgery
• Oral and Maxillofacial Surgery
• Regenerative Medicine

Background:

• Mandibular defects pose significant reconstruction challenges.
• Vascularized fibular flaps are increasingly favored for their versatility and reliability.
• Long-span defects require robust bone grafting solutions.

Purpose of the Study:

• To report the authors' positive experience with free vascularized fibular grafts in mandibular reconstruction.
• To evaluate the efficacy and outcomes of this technique for long defects.
• To assess both functional and aesthetic results, as well as donor site morbidity.

Main Methods:

• Retrospective analysis of 14 consecutive cases using free vascularized fibular grafts.
• Inclusion of skin paddles in ten cases.
• Assessment of graft viability, flap survival, and patient-reported outcomes.
• Evaluation of donor site complications and functional recovery (mouth opening).

Main Results:

• Successful reconstruction in all cases with no total flap loss.
• Good bone viability confirmed by scintigraphy in most cases.
• Satisfactory to excellent postoperative facial appearance and mouth opening (21-50 mm).
• Minimal donor site complications, with one instance of skin necrosis and one wound rupture.

Conclusions:

• The free vascularized fibular graft is a reliable and effective method for reconstructing long mandibular defects.
• The technique provides good functional and aesthetic outcomes with acceptable morbidity.
• It represents a valuable option for both primary and secondary mandibular reconstructions.