Autelitano L, Colletti G, Bazzacchi R, Biglioli F
Department of Maxillo-Facial Surgery, San Paolo University Hospital, Milan, Italy.
Int J Oral Maxillofac Surg. 2008 Jul;37(7):669-71. doi: 10.1016/j.ijom.2008.01.023. Epub 2008 Mar 26.
The fibular free flap is the most widely used flap for jaw reconstruction. Flap contouring requires removal of bone excess in the proximal segment by a subperiosteal dissection, preserving vascular connections between the pedicle and the bone and leaving well vascularized periosteum attached to the vascular pedicle. Among about 100 reconstructions with fibular flaps, 4 cases were observed of abnormal ossification along the vascular pedicle. Periosteum preserves its osteogenic capability after transposition, especially in a revascularized flap; this characteristic, together with the direct contact with the bone, allows the possibility of new bone formation along the pedicle. It would appear necessary to change the technique of reducing fibular excess, with removal of periosteum together with the bone, in order to avoid the complication described.
腓骨游离皮瓣是颌骨重建中应用最广泛的皮瓣。皮瓣塑形需要通过骨膜下剥离去除近端多余的骨质，保留蒂部与骨之间的血管连接，并使血运良好的骨膜附着于血管蒂。在约100例腓骨皮瓣重建病例中，观察到4例血管蒂周围出现异常骨化。骨膜移位后仍保留其成骨能力，尤其是在血运重建的皮瓣中；这一特性，加上与骨的直接接触，使得沿蒂部有形成新骨的可能。为避免上述并发症，似乎有必要改变减少腓骨多余部分的技术，即连同骨一起去除骨膜。
