血管化腓骨肌皮瓣修复下颌骨缺损

Reconstruction of mandibular defects with vascularized fibular osteocutaneous flap

摘目的：总结应用腓骨肌皮瓣修复下颌骨缺损的经验。方法：对8例因肿瘤切除造成的下颌骨缺损患者，用血管化腓骨肌皮瓣修复。将腓骨截为2-4段以恢复下颌骨外形，用钛板内固定，皮瓣用于修复软组织缺损或作为观察其血液循环的观察窗。结果：8例患者移植的腓骨肌皮瓣全部成活，颌面部外形和功能恢复良好。结论：可根据下颌骨缺损的部位和形态对腓骨肌皮瓣进行截骨和塑形。血管化的腓骨肌皮瓣移植是下颌骨缺损较为理想的修复方法。

Objective：To summarize the experience of reconstruction of mandibular defects with vascularized fibular osteocutaneous flap. Methods：Segmental mandibular resection and immediate reconstruction with vascularized fibular osteocutaneous flap were performed in 8 patients with tumor. The fibula flaps were cut into 2 - 4 segments and bent to the contour of the mandibles, and they were fixed precisely by the titanium plate. The skin flaps were used for reconstruction of soft tissue defects or as observation windows of the blood circulation. Results：In all 8 patients, transplanted vascularized fibular osteocutaneous flaps survived well, and restoration of mandibular contour and function was satisfactory. Conclusion ：The fibular osteocutaneous flap can be cut into segments and shaped according to location and contour of mandibular defect. Vascularized fibular osteoeutaneous flap may be an ideal selection for the reconstruction of mandibular defect.