血管化腓骨组织瓣游离移植修复下颌骨缺损

The Utility Of Vascularized Free Fibula Flap in Mandibular Reconstruction

目的:探讨血管化腓骨修复各型下颌骨缺损的可行性。方法:对14例因各种原因所致下颌骨缺损患者采用血管化游离腓骨瓣同期移植修复。结果:骨瓣存活成功率100%;下颌骨形状和功能恢复良好。术后3个月摄片示移植骨无吸收,骨段愈合良好。面部外形恢复均达到满意或较为满意。所有患者均能正常行走,无1例出现踝关节不稳定。结论:游离腓骨瓣血供良好,骨量充足,可塑性强,特别是对全下颌骨缺损的修复,具有目前临床常用的其他自体骨组织瓣不可比拟的优点,是下颌骨缺损修复重建的最佳方法之一。

Objective: To find a new treatment to reconstruct the defects of mandible. Methods: 14 patients with mandibular defects were reconstructed by fibula free flaps after ostectomy immediately. Results: All flaps were survival with the success rate of 100%. The function and contour of the mandible were excellent. Facial contour in all patients was graded to be very good. X-ray films were taken to observe bone flap healing 3 months after surgery. And the aesthetic assessments in all patients were good or fair. no ankle unstability were reported. Conclusion: Fibula free flap has a good blood supply and high density of cortical bone. There is enough bone available. Vascularized free fibula flap takes its distinct advantages to other autogeneous free bone flaps and is confirmed to be one of the optimal methods for mandible reconstruction by our study.