Reconstruction of a bilateral mandibular defect due to trauma using a single fibula free flap.

The reconstruction of noncontiguous bilateral mandibular defects using a single bony free flap is rarely performed because such defects are seldom encountered. This report describes the reconstruction of a bilateral body defect caused by shrapnel injury. A free vascularized osteomyocutaneous fibula flap was designed to replace 2 mandibular defects in the patient. The midportion of the fibula was resected without damage to the periosteum and vascular pedicle, and a skin paddle was used to monitor the flap. This would appear to be the first report of its use in the reconstruction of bilateral mandibular defects from trauma.