RECONSTRUCTION OF MANDIBLE WITH FIBULA FREE-FLAP

The fibula can be used as a donor for a free flap for mandible reconst ruction. II has the advantages of low donor site morbidity, consistent shape, ample length, and distant location to enable a two-team approa ch, allowing multiple osteotomies because of its periosteal circulatio n. It can be raised with a skin island for composite tissue reconstruc tion. Eight segmental mandibular defects (average 11.62 cm) were recon structed following resection for tumour. Six defects consisted of bone alone and the other two had only a small amount of associated intraor al soil-tissue loss. Two patients underwent primary reconstruction. We performed two or three osteotomies on each graft and used miniplates and wires for bone fixation. The flaps survived in all patients. All o steotomy sites healed primarily. The aesthetic result of reconstructio n was satisfactory. (C) 1998 Wiley-Liss, Inc.