游离腓骨复合组织瓣同期修复上下颌骨缺损:1例报告

Simultaneous maxillary and mandibular reconstruction with a single free fibula composite flap: A case report

本文介绍1例游离腓骨瓣同期修复上下颌骨缺损,对其治疗设计及并发症作一临床分析。腓骨瓣同期修复上下颌骨缺损为颌骨重建提供了新思路,可应用于某些特殊病例的治疗,准确的术前设计及细致的腓骨塑形是手术的关键。本病例术后4个月上下颌移植腓骨块之间形成骨桥,导致张口受限,是血管蒂附带的腓骨骨膜成骨所致,再次手术切除骨桥及骨膜,并随诊2.5a,未再出现张口受限。

In this paper, one-stage bony reconstruction of both the maxilla and mandible with just one free fibula flap was reported. Preoperative planning, surgical technique, postoperative complication and prosthetic restoration were discussed in detail. In some special patients, a single fibula flap can be fit for the bone defects of both maxilla and mandible. Accurate planning and careful contouring of the fibula bone are very important. At the fourth month after the operation, the patient had severe trismus, a solid bone bridge from the maxilla to mandible was found in X-ray and CT scan films. The well-vascularized periosteum adjacent to the vascular pedicle of the fibula had significant osteogenic potential. The resection of the bone bridge and periosteum was performed. The patient had no trismus any more with the follow-up period of 2.5 years.