Microsurgery. 2025 Dec;45(8):e70157. doi: 10.1002/micr.70157.
ABSTRACT
BACKGROUND: Segmental mandibular reconstruction with osteocutaneous fibular free flaps commonly employs end-to-end (E-T-E) wedge osteotomies. However, excessive osteotomies or limited fibular length can compromise vascularity, bony union, available pedicle length. This study evaluates the outcomes of a modified end-to-side (E-T-S) fibular strut configuration in mandibular reconstruction.
METHODS: A retrospective analysis was conducted on 11 patients who underwent mandibular reconstruction using fibular free flaps with at least one E-T-S osteotomy between 2017 and 2021. Bony union was assessed radiographically ≥ 12 months postoperatively and categorized as complete (CBU) or incomplete bony union (IBU). Complication rates were also analyzed.
RESULTS: Among 33 junctions, 11 were reconstructed using the modified E-T-S approach. Of these, 7 achieved complete bony union. In the remaining 22 junctions reconstructed with E-T-E osteotomies, 15 achieved complete bony union.
CONCLUSION: Descriptively, the union rates observed in modified E-T-S osteotomies were similar to those seen in conventional E-T-E reconstructions. It offers a viable alternative in complex reconstructions where pedicle length, anatomy, or perfusion constraints preclude standard approaches.
PMID:41399914 | DOI:10.1002/micr.70157