Conformation of the fibula flap to passively adapt to the remaining mandible may be indeed challenging. A review of the 'axial splitting' technique for fibula free flaps is presented with a novel method of osteosynthesis. Adequate mandibular angle shape is achieved by performing this type of osteotomy with a minimal use of titanium hardware for flap insetting.
Keywords: Fibula free flap; Fibula osteotomies; Head and neck reconstruction; Mandible reconstruction; Microvascular reconstruction.