Reconstruction of large segment of mandible using a free vascularized osteocutaneous fibula flap: Report of two cases.

概要

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Vascularized free fibular flaps, raised with associated skin island, has been used to reconstruct a large mandibular defect including the middle third of the mandible in two cases. Although additional surgical procedure to correct the shape of the graft was needed in one patient, a fibular bone could be molded to the appropriate contour by means of osteotomies and fixations with miniplates in both cases. The small skin island was used for the purpose of monitoring the blood supply to the bone graft in one patient, and the large skin island was employed for covering the skin defect of the recipient site in the other. In the former patient, in spite of partial necrosis of the monitoring skin island, the bone graft survived completely. The latter had no trouble in the recipient site with survival of the bone and skin grafts. However the latter patient had trouble in the donor site with a slight functional deficit caused by prolonged wound infection.<BR>These two cases have taught us that vascularized free fibular graft is useful in reconstruction of mandibular defect particularly in such a large segment as this; however, the problems relating to the skin island or management of the donor site must be considered.
社団法人日本口腔外科学会の論文