BLOOD-SUPPLY OF SMALL FIBULA SEGMENTS - AN EXPERIMENTAL-STUDY ON HUMAN CADAVERS

When vascularized fibula grafts are used in mandibular reconstruction, it is often necessary to divide the graft into segments so as to foll ow the mandibular curvature, The periosteal blood supply to the segmen ts is usually sufficient. It is unclear, however, how short the segmen ts can be without compromising the blood supply The present study soug ht to clarify this issue by injecting Indian ink into the efferent ves sels in human cadavers. The evaluation of 300 specimens showed the ink perfusion to be significantly higher in segments longer than 1 cm tha n in shorter segments, Furthermore, the perfusion in the cortical oute r third of the shaft was markedly higher than in the cortical inner tw o-thirds. The staining was significantly more intense in the younger ( 32-55 years) than in the older (56-73 years) age group. With correct d issection and successful anastomosis, however, fibula segments 1 cm or longer are probably sufficiently perfused, independent of the patient 's age, The perfusion in shorter segments is uncertain. Clinically thi s means that segments shorter than 1 cm ought to be used only in a sur gically noncompromised recipient site, where they could also take as n on-vascularized grafts.