International Journal of Head and Neck Surgery

Register      Login

VOLUME 13 , ISSUE 2 ( April-June, 2022 ) > List of Articles


Complications of Flap Fibula Osteomyocutaneous in Pediatric Patients

Larissa B Zavarez

Keywords : Flap fibular, Mandible, Reconstruction

Citation Information : Zavarez LB. Complications of Flap Fibula Osteomyocutaneous in Pediatric Patients. Int J Head Neck Surg 2022; 13 (2):67-70.

DOI: 10.5005/jp-journals-10001-1427

License: CC BY-NC 4.0

Published Online: 17-09-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: Defects in the mandible or maxilla are usually obtained from broad resections of advanced oral cancer, benign tumors of aggressive clinical course, or accidents. These defects require the replacement of tissue lost by similar characteristics tissue preserving the quality of life of patients through rehabilitation of function and esthetics. This flap provides a greater volume of bone tissue grafts from all bone and generates little morbidity in the donor site is capable of undergoing multiple osteotomies by modeling. This flap provides the greatest amount of bone tissue between all bone grafts; causes little morbidity in the donor area, lending itself also to modeling by osteotomies, allowing its adaptation to any defect. Materials and methods: A retrospective study evaluating the medical records from 1995 to 2014 the medical records of nine patients undergoing reconstructive treatment with flap fibular. Discussion: The reconstruction with microsurgical flap fibular technique used can progress to a partial or total loss of the flap, as well as an esthetic and functional sequel in the recipient area and donor, which varies with the flap selected, this study had no failure of clinical cases. Results: Complications were minimal, there were four (33%) of patients. Conclusion: Complications were of minimal complexity and resolved. There was no flap fibula rejection in any case. This shows that the protocol and the results obtained by the team in reconstructive surgery with osteomyocutaneous fibular graft are within the biological and protocol standards of service.

  1. Regezi JA, Sciubba JJ. Patologia Bucal, Correlações Clínico-patológicas. 1st ed., Rio de Janeiro: Guanabara Koogan; 1991.
  2. Wei FC, Seah CS, Tsai YC, et al. Fibula osteoseptocutaneous flop reconstuction of composite mandibular defects. Plast Reconstr Surg 1994;93(2):294–304. DOI: 10.1097/00006534-199402000-00009
  3. Lee H, Ercoli C, Fantuzzo JJ, et al. Oral rehabilitation of a 12-year-old patient diagnosed with a central giant cell granuloma using a fibula graft and an implant-supported prosthesis: a clinical report. J Prosthet Dent 2008;99(4):257–262. DOI: 10.1016/S0022-3913(08)60057-8
  4. Gerhadt E. Use of the fibula free flap in the oral and maxillofacial complex:a report of two cases. Rev Cir Traumatol Buco-Maxilo-Fac, Camaragibe v.5, n. 4 2005. 23–30. outubro/dezembro.
  5. Puriccelli E, Chem RC, Rinaldi S. Mandible reconstruction using the fibule. In: 8th Congress of European Association for Maxillofacial, Madrid, Espanha, Sept, 1986.
  6. Hidalgo DA. Fibula free flap: a new method of mandible reconstruction. Plast Reconstr Surg 1989;84(1):71–79. DOI: 10.1097/00006534-198907000-00014
  7. Mendonça JCG, PaGliarelli PRS, Bento LA, et al. Ameloblastoma letal de maxila: relato de caso. Rev Bras Cir Craniomaxilofacial 2009;12(2):85–88.
  8. Ariel L, Takamori ER. Reabilitação oral de pacientes com sarcoma indiferenciado em mandíbula utilizando-se enxerto de fíbula e prótese sobre implante. Innov Implant, Biomater Esthet SP 2009. v 4, n. 1 69–74.
  9. Neville BW, Damm DD, Allen CM, et al. Patologia Oral Maxilofac. 2a ed., Rio de Janeiro: Guanabara Koogan; 2008. pp. 586–594.
  10. Sassi LM, Oliveira BV, Radaelli RL, et al. Oral rehabilitation post mandible tumor excision with titanium osseointegrated implants in a microvascularised fíbula graft. Inter J Oral Maxillofac Surg 2001;30(suppl A):S15.
  11. Silva JB, Martins ODE, Roman JA, et al. Reconstrução do segmento ósseo mandibular; comportamento dos implantes ósseos integrados nos retalhos vascularizados de crista ilíaca e fíbula. Soc Brasileira de Cirurgia Plástica 2005;20(3):176–181.
  12. Mark L, Smith MD, Emily Clarke–Pearson MD, et al. Fibula osteo-adipofascial flap for mandibular and maxillary reconstruction. Head Neck 34(10):1389–1394. DOI: 10.1002/HED
  13. Fujiki M, Miyamoto S, Sakuraba M, et al. A comparison of perioperative complications following transfer of fibular and scapular flaps for immediate mandibular reconstruction. J Plast Reconstr Aesthe Surg 2013;66(3):372–375. DOI: 10.1016/j.bjps.2012.10.003
  14. Hidalgo DA, Pusic AL. Free flap mandibular reconstruction: a 10 year follow up study. Plast Reconstr Surg 2002;110(2):438–449. DOI: 10.1097/00006534-200208000-00010
  15. Prein J. Manual of Internal Fixation in the Cranio-facial Skeleton. Berlin: Springer-Verlag; 1998.
  16. Ferri J, Piot B, Ruhin B, et al. Advantages and limitations of the fibula free flap in mandibular reconstruction. J Maxillofac Surg 1997;55(5):440–448. DOI: 10.1016/S0278-2391(97)90685-6.
  17. Machado ER, Portinho CP, Vasconcelos RAT, et al. Extremity reconstruction using a free fbula fap after oncological resection. Rev Bras Cir Plást 2012;27(3):461–465. DOI: 10.1590/S1983-51752012000300023
  18. Portinho CP, Russano M, Sbal Chiero JC, et al. Complicações da área doadora pós-fibulectomia para reconstrução microcirúrgica de mandíbula. Rev Bras Cir Craniomaxilofac 2010;13(3):153–155.
  19. Momoh AO, Yu P, Skoracki RJ, et al. A prospective cohort study of fíbula free flap donor-site morbidity in 157 consecutive patients. Plast Reconstr Surg 2011;128(3):714–720. DOI: 10.1097/PRS.0b013e318221dc2a
  20. Shindo M, Fong BP, Funk GF, et al. The fíbula osteocutaneous flap in head and neck reconstruction: a critical evaluation of donor site morbisity. Arch Otoryngol Head Neck Surg 2000;126(12):1467–1472. DOI: 10.1001/archotol.126.12.1467.
  21. Sieg P, Taner C, Hakim SG, et al. Long-term evaluation of donor site morbidity after free fibula transfer. Br J Oral Maxillofac Surg 2010;48(4):267–270. DOI: 10.1016/j.bjoms.2009.07.019.
  22. Aydin A, Emekli U, Erer M, et al. Fibula free flap for mandible reconstruction. Kulak Burun Bogaz Ihtis Derg 2004;13(3–4):62–66.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.