Fibula Free Flap in Reconstruction of Mandibular Defects

Purpose: To study a series of cases where vascularised fibula flap was used in mandibular defect.

Patients and Method: The investigators designed a retrospective study composed of patients with any pathology or defect who underwent reconstruction of mandible with vascularised fibula free flap from 2014 to 2018. All patients were evaluated for age, gender, location and type of defect, incorporation of adjoining skin paddle and muscle, number of fibula osteotomies, ischaemia time, anticoagulant regimen, length of hospital stay, flap failure rate, dental implant rehabilitation. All patients with a minimum follow-up of 6 months post-operatively, were included in this study.

Results: The study sample composed of 8 patients with average age of 40 years. Immediate reconstruction done in all patients. In two patients, the fibula was double barrelled. Skin island was included with the fibula in all patients. Two patients underwent dental rehabilitation using implantswith double barrel reconstructions. Hematoma at the recipient site was the commonest post-operative complication, although itsfrequency was low. A low donor site morbidity was seen. Average stay in hospital was about 10 days. Post-operatively all patients ambulated normally and none used assisted devices. A reconstruction plate was used to achieve the ideal contour of the jaw in most cases. Aesthetic results were usually good, especially in young patients. The overall success rate was good. Conclusion: The fibula has many assets which make it the ideal choice for bony reconstruction of mandible skeleton and adjoining soft tissue with predictable results.