Vascularized free fibula flap for reconstruction of mandibular defects

Objective: To assess the versatility of vascularized free fibula flap in reconstruction of various defects of mandible. Study Design: Prospective study. Duration of Study: March 2009 to March 2012. Methodology: The study group consisted of 10 patients who underwent resection of mandible for various reasons and reconstruction of continuity defects using a vascularized free fibular flap. The mandible was resected for ameloblastoma in 4 cases, squamous cell carcinoma in 1 case, odontogenic keratocysts in 3 cases and ossifying fibroma in 2 cases. The type of reconstruction performed was primary in 9 patients in which osseous fibula flap was used and secondary in 1 patient in which osseocutaneous flap was used. Results: There were 10 patients which include 5 males and 5 females within age group of 20 to 50 years with mean age of 35 years. All flaps survived except in 1 patient who had donor site morbidity. Flap perfusion was seen immediately after anastomosis and was maintained throughout the follow-up period of minimum 6 months. All patients were kept in nasogastric feeding for 5 days and then began oral feeding and walking with some aid in 2 week and became completely ambulant in 4 week postoperatively. Conclusion: In our study, we conclude that vascularized free fibula flap is a versatile option for reconstruction of large mandibular defects with its good quality and quantity of bone and ease of manipulation to restore the original anatomy of the mandible and permit implant based prosthetic rehabilitation.