Vascularized metatarsal transfer in mandibular reconstruction

Adequate reconstruction of the mandible when associated with a mucosal deficit requires an osteocutaneous component in which the skin is closely associated with the bone. A curve in the bony framework to simulate the curvature of the mandible is required when the defect is in the anterior segment. The second metatarsal and toe osteocutaneous flap can provide such a mandibular mucosal replacement and has been used successfully for eighteen years.