Hurczulack Marcio Vinícius, Guebur Maria Isabela, Albrecht Ramos Gyl Henrique, Duarte da Silva Alfredo Benjamin, Sassi Laurindo Moacir
Oral and Maxillofacial Surgery Department, Erasto Gaertner Hospital, R. Dr. Ovande do Amaral, 201-Jardim das Americas, Curitiba, PR 81520-060 Brazil.
Head and Neck Surgery Department, Erasto Gaertner Hospital, Curitiba, Paraná Brazil.
J Maxillofac Oral Surg. 2024 Apr;23(2):235-241. doi: 10.1007/s12663-021-01536-x. Epub 2021 Mar 13.
Reconstruction of large mandibular defects requires reestablishment of mandibular continuity with bone and soft tissue. The microvascularized fibula flap (MFF) has the advantage of providing both, with adequate length, low resorption rate, low infection risk and possibility of dental implant insertion. It can be adapted to mandibular defects in many different ways.
This retrospective study will present and evaluate the results of the joint technique for flap positioning and fixation.
The technique consists of designing osteotomies on the binding edge of the MFF and recipient jaw, increasing bone contact from one to five faces. Patients submitted to mandibular reconstruction through this technique were included and evaluated regarding systemic compromise, complication occurrence as well as primary and long-term stability.
Ten patients underwent mandibular reconstruction with the joint technique. Sixteen joints were applied, and excluding an early loss due to vascular failure, all remaining 14 joints healed uneventfully. None showed signs of early or late mobility.
Fitting the MFF through a joint that provides greater bone contact may improve stability and reduce screw loosening and mini-plate removal rates.
大型下颌骨缺损的重建需要通过骨组织和软组织重建下颌骨的连续性。带微血管蒂的腓骨瓣（MFF）具有能同时提供这两者的优势，其长度足够、吸收率低、感染风险低且有可能植入牙种植体。它可以通过多种不同方式适应下颌骨缺损。
本回顾性研究将展示并评估联合皮瓣定位与固定技术的结果。
该技术包括在MFF和受区颌骨的结合边缘设计截骨术，将骨接触从一个面增加到五个面。纳入通过该技术进行下颌骨重建的患者，并对其全身状况、并发症发生情况以及初期和长期稳定性进行评估。
10例患者采用联合技术进行下颌骨重建。应用了16个关节，排除因血管衰竭导致的早期丢失，其余14个关节均顺利愈合。无一例出现早期或晚期活动迹象。
通过提供更大骨接触的关节来适配MFF，可能会提高稳定性并降低螺钉松动和微型钢板取出率。
