腓骨肌(皮)瓣一期整复下颌骨缺损

The Reconstruction of Mandibular Defects with Fibula Free Flap

目的 应用游离腓骨肌 (皮 )瓣一期整复下颌骨缺损。方法 以腓动静脉为血管蒂切取腓骨肌瓣 ,根据下颌骨缺损的特点 ,对腓骨进行截骨塑形 ,按定位钢板定位后的下颌骨缺损形态和长度准确就位 ,用小钛板或重建板进行移植骨坚固内固定。结果 18例腓骨肌瓣重建下颌骨缺损全部获得成功。腓骨截成二段者 10例 ,三段者 3例 ,5例未截断。术后伤口均一期愈合 ,术后面部外形恢复满意者 16例 ,咬合关系正常者 14例 ,张口度正常者 14例 ,3例患者术后接受活动义齿修复 ,1例行种植义齿修复并获得良好的咀嚼功能。结论 腓骨肌瓣是重建下颌骨缺损的理想组织瓣 ,其具有骨量充足、外形好、成功率高等优点。

Objective To study the clinical application of fibula free flap to the reconstruction of mandibular defects.Methods 18 patients with mandibular defects were reconstructed with fibula free flap.The fibula free flaps were based on the perennial vessel.They were cut into segments and shaped according to the features of the mandibular defects.Application of template and preparted fixed reconstrucion plate made the grafted bone plac precisely and then rigidly fixed with titanium miniplate or reconstruction plate.Results All the 18 fibula free flaps survived well without failure.The wounds healed well.The fibula flaps were divided into 2 segments in 10 cases,and 3 segments in 3 cases.16 patients were satisfied with their final esthetic results.14 patients obtained normal occlusal relationship and 14 patients achieved normal degree of mouth opening.However,only 3 cases accepted the conventional rehabilitation.Conclusion The fibula free flap is a more ideal method for the reconstruction of mandbiular defects currently.