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Lag-screw technique in free osseous mandibular reconstruction
P J Capizzi1, W M Jacobsen, N B Meland
1Division of Plastic and Reconstructive Surgery, Mayo Clinic Scottsdale, Arizona 85259, USA.
Journal of Reconstructive Microsurgery
|April 2, 1998
Summary
Lag-screw fixation provides rigid fixation for mandibular reconstruction using AO vascularized bone grafts. This technique avoids the need for maxillomandibular fixation, simplifying the procedure and ensuring graft viability.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthopedic Surgery
- Biomaterials Science
Background:
- Mandibular reconstruction is crucial for restoring function and aesthetics after trauma or resection.
- Traditional methods often require maxillomandibular fixation, increasing patient morbidity.
- The need for reliable and efficient fixation techniques for vascularized bone grafts is paramount.
Purpose of the Study:
- To evaluate the efficacy and safety of lag-screw fixation for securing AO vascularized bone grafts in mandibular reconstruction.
- To assess the impact of lag-screw fixation on the need for maxillomandibular fixation.
- To determine the long-term viability and outcomes of reconstructed mandibles using this technique.
Main Methods:
- Retrospective review of a surgical registry (1988-1992) for mandibular reconstruction cases.
- Analysis of 17 patients who underwent microvascular bone grafting with lag-screw fixation (AO technique, 2.7-mm cortical screws).
- Assessment of graft viability using bone scans and clinical follow-up for complications.
Main Results:
- Lag-screw fixation provided rigid fixation for mandibular defects ranging from 6 to 20 cm.
- All AO vascularized bone grafts remained viable, confirmed by bone scans.
- No flap losses or oral cutaneous fistulae were observed post-operatively.
Conclusions:
- Lag-screw fixation is a safe and effective method for securing AO vascularized bone grafts in mandibular reconstruction.
- This technique offers rigid fixation, eliminates the need for maxillomandibular fixation, and is easy to apply.
- Lag-screw fixation represents a significant advancement in improving outcomes for patients undergoing mandibular reconstruction.
