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Case report
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Background: The reconstructive and rehabilitative management of large mandibular defects is challenging in many respects, especially in the vertical dimension. The free fibula flap is an under-utilised but efficient approach in this indication. The aim of this case series is to demonstrate its use and long-term success.
Case presentation: Three cases are presented, where the patient had a large bone defect (at least 5 cm in length and 1 cm in the vertical dimension), but the continuity of the mandible was maintained. Two cases were related to pathological fracture and one was a large defect due to oncological surgery. Vertical augmentation with free microvascularised fibula flap was carried out, followed by implant-retained prosthetic therapy. Clinical status has been followed up for 5 to 6 years, with special attention to the condition of the peri-implant tissues and any radiographically detectable alterations or complications. No complications occurred during the follow-up. Function and esthetics have remained unchanged throughout.
Conclusions: Free microvascularised fibula flap reconstruction combined with implant-retained prosthetics allows a lasting functional and esthetic solution in large vertical mandible defects.
Keywords
mandibular defect, reconstructive surgery, free fibula flap, implant-retained prosthetics
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CURRENT STATUS: Published
View the published article at Head & Face Medicine.
Version 1
Posted 12 Nov, 2020
No community comments so far
Editorial decision: Major revision
On 09 Mar, 2021
Review #3 received
Received 26 Feb, 2021
Reviewer #3 agreed
On 13 Feb, 2021
Reviewer #2 agreed
On 10 Feb, 2021
Review #2 received
Received 10 Feb, 2021
Reviewer #1 agreed
On 22 Dec, 2020
Review #1 received
Received 22 Dec, 2020
Reviewers invited
Invitations sent on 12 Nov, 2020
Editor assigned
On 10 Nov, 2020
Editor invited
On 10 Nov, 2020
Submission checks complete
On 10 Nov, 2020
First submitted
On 08 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Head & Neck Surgery
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A new preprint design is coming!
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See the published version of this preprint at Head & Face Medicine.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Case report
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Head & Face Medicine.
Version 1
Posted 12 Nov, 2020
No community comments so far
Editorial decision: Major revision
On 09 Mar, 2021
Review #3 received
Received 26 Feb, 2021
Reviewer #3 agreed
On 13 Feb, 2021
Reviewer #2 agreed
On 10 Feb, 2021
Review #2 received
Received 10 Feb, 2021
Reviewer #1 agreed
On 22 Dec, 2020
Review #1 received
Received 22 Dec, 2020
Reviewers invited
Invitations sent on 12 Nov, 2020
Editor assigned
On 10 Nov, 2020
Editor invited
On 10 Nov, 2020
Submission checks complete
On 10 Nov, 2020
First submitted
On 08 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Head & Neck Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Head & Face Medicine.
Background: The reconstructive and rehabilitative management of large mandibular defects is challenging in many respects, especially in the vertical dimension. The free fibula flap is an under-utilised but efficient approach in this indication. The aim of this case series is to demonstrate its use and long-term success.
Case presentation: Three cases are presented, where the patient had a large bone defect (at least 5 cm in length and 1 cm in the vertical dimension), but the continuity of the mandible was maintained. Two cases were related to pathological fracture and one was a large defect due to oncological surgery. Vertical augmentation with free microvascularised fibula flap was carried out, followed by implant-retained prosthetic therapy. Clinical status has been followed up for 5 to 6 years, with special attention to the condition of the peri-implant tissues and any radiographically detectable alterations or complications. No complications occurred during the follow-up. Function and esthetics have remained unchanged throughout.
Conclusions: Free microvascularised fibula flap reconstruction combined with implant-retained prosthetics allows a lasting functional and esthetic solution in large vertical mandible defects.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
This is a list of supplementary files associated with this preprint. Click to download.
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