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Techniques on modeling the vascularized free fibula flap in mandibular reconstruction.
J Craniofac Surg. 2009 Sep; 20(5):1571-3.JC

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.

Authors+Show Affiliations

Department of Maxillo-Facial Surgery, Catholic University Medical School, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19816298

Citation

Moro, Alessandro, et al. "Techniques On Modeling the Vascularized Free Fibula Flap in Mandibular Reconstruction." The Journal of Craniofacial Surgery, vol. 20, no. 5, 2009, pp. 1571-3.
Moro A, Cannas R, Boniello R, et al. Techniques on modeling the vascularized free fibula flap in mandibular reconstruction. J Craniofac Surg. 2009;20(5):1571-3.
Moro, A., Cannas, R., Boniello, R., Gasparini, G., & Pelo, S. (2009). Techniques on modeling the vascularized free fibula flap in mandibular reconstruction. The Journal of Craniofacial Surgery, 20(5), 1571-3. https://doi.org/10.1097/SCS.0b013e3181b0db5c
Moro A, et al. Techniques On Modeling the Vascularized Free Fibula Flap in Mandibular Reconstruction. J Craniofac Surg. 2009;20(5):1571-3. PubMed PMID: 19816298.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Techniques on modeling the vascularized free fibula flap in mandibular reconstruction. AU - Moro,Alessandro, AU - Cannas,Raffaela, AU - Boniello,Roberto, AU - Gasparini,Giulio, AU - Pelo,Sandro, PY - 2009/10/10/entrez PY - 2009/10/10/pubmed PY - 2010/1/29/medline SP - 1571 EP - 3 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 20 IS - 5 N2 - 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. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/19816298/Techniques_on_modeling_the_vascularized_free_fibula_flap_in_mandibular_reconstruction_ L2 - https://doi.org/10.1097/SCS.0b013e3181b0db5c DB - PRIME DP - Unbound Medicine ER -