Techniques on modeling the vascularized free fibula flap in mandibular reconstruction

Alessandro Moro, Giulio Gasparini, Roberto Boniello, Sandro Pelo

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

35 Citazioni (Scopus)

Abstract

In mandibular reconstruction with bone grafts, the functional and aesthetic outcomes are clearly influenced by reconstructive techniques. Vascularized free fibular flaps are considered the most suitable choice for mandible reconstruction because of their good aesthetic and functional outcomes. Several techniques have been described in literature. According to various authors, shaping of the fibular graft can be performed by means of computer-aided design/computer-aided modeling procedures for the evaluation of the presurgery anatomy and three-dimensional models of fibula graft. However, these models are expensive, require a strict realization of the programmed intervention, and are not easily adaptable to a surgical treatment different from the planned one. We report our experience on a technique for mandibular reconstruction using a free fibular flap, obtained by modeling a template on the resected mandible. Our operative technique consists of 5 steps: preplating, resection, template modeling, contouring of the fibula, and fixing the flap on the mandible.Template modeling is performed to record the length of the resected bone, the mandibular curvature on the 3 space planes, and the width of the basal bone. On the basis of the template, the fibula flap was modeled while still attached to the pedicle. The plates, positioned at the level of the fibular osteotomies, were preformed to make the fibula precisely fit in the template. Once the fibula was shaped, mandibular reconstruction was completed by positioning the fibula graft on the mandibular stumps. Bone graft modeling by means of template is a rapid, safe, and flexible method to reconstruct the mandible.
Lingua originaleEnglish
pagine (da-a)1571-1573
Numero di pagine3
RivistaTHE JOURNAL OF CRANIOFACIAL SURGERY
Volume20
DOI
Stato di pubblicazionePubblicato - 2009

Keywords

  • Bone Plates
  • Bone Transplantation
  • Computer-Aided Design
  • Fibula
  • Humans
  • Imaging, Three-Dimensional
  • Mandible
  • Mandibular Neoplasms
  • Osteotomy
  • Patient Care Planning
  • Reconstructive Surgical Procedures
  • Surgical Flaps
  • Tissue and Organ Harvesting

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