Pediatric mandibular reconstruction using a vascularized fibula flap

Head Neck. 2008 Mar;30(3):311-9. doi: 10.1002/hed.20695.

Abstract

Background: The purpose of this study was to address questions concerning the functional outcome following mandibular reconstruction with vascularized fibula flap in skeletally immature children

Methods: Eleven patients 14 years old or younger who underwent mandibular reconstruction using a free fibula flap were evaluated.

Results: The mean follow-up was 3.4 years. One flap loss occurred and required a second fibula flap. Panorex radiographs showed good bone union and growth in all patients. Functional outcomes were normal according to age in all patients. Two patients had long-term malocclusion. No patients had to undergo corrective orthognathic surgery. Donor-site morbidities consisted of great toe flexion contracture (n = 4) and a valgus deformity (n = 1). All patients had a normal gait, and there were no discrepancies in leg length.

Conclusion: A mandible reconstructed using a vascularized fibula flap appears to grow accordingly as the child grows, with minimal disturbance to the growth pattern of the midface.

MeSH terms

  • Adolescent
  • Bone Plates
  • Child
  • Child, Preschool
  • Dental Occlusion
  • Device Removal
  • Esthetics
  • Female
  • Fibula / transplantation*
  • Follow-Up Studies
  • Humans
  • Male
  • Mandible / surgery*
  • Mandibular Neoplasms / surgery
  • Osteogenesis
  • Plastic Surgery Procedures / methods*
  • Surgical Flaps / blood supply*
  • Treatment Outcome