Davidson J, Boyd B, Gullane P, Rotstein L, Freeman J, Manktelow R, Rosen I
Division of Plastic Surgery, University of Toronto, Ontario, Canada.
Plast Reconstr Surg. 1991 Aug;88(2):201-8. doi: 10.1097/00006534-199108000-00004.
Fifteen cases of oromandibular reconstruction using a radial osteocutaneous flap were compared with 16 in which the mandible was replaced with a reconstruction plate and a forearm flap was used for intraoral lining. All cases involved oral cancer; most had been irradiated. Nine survived in each group. Complications included one infected nonunion in addition to two bone exposures in the bone group, compared with three cases of plate exposure and two bone exposures in the plate group. Functional results were similar in both, but osteointegrated implants were possible only in the patients receiving bone. Cosmesis seemed somewhat better in the plate group. Donor-site problems were common but minor, and long-term forearm function was slightly reduced in both groups. Although the sample sizes were small, the reconstruction plate together with a radial forearm flap appeared to provide effective reconstruction following composite resection. However, we would not recommend this for the younger patient or in benign disease.
对15例采用桡骨骨皮瓣进行口下颌重建的病例与16例采用重建钢板置换下颌骨并使用前臂皮瓣进行口内衬里的病例进行了比较。所有病例均为口腔癌；大多数患者曾接受过放疗。每组各有9例存活。并发症方面，骨瓣组除2例骨外露外，还有1例感染性骨不连，而钢板组有3例钢板外露和2例骨外露。两组的功能结果相似，但仅接受骨瓣的患者可以植入骨整合种植体。钢板组的美容效果似乎稍好一些。供区问题常见但不严重，两组的长期前臂功能均略有下降。尽管样本量较小，但重建钢板联合桡骨前臂皮瓣似乎能在复合切除术后提供有效的重建。然而，我们不建议年轻患者或良性疾病患者采用这种方法。
