Practical technique for predictable wedge osteotomies during microvascular free fibula reconstruction after mandibulectomy

摘要

The free fibula flap is the workhorse flap for mandibular reconstruction. The good bone stock, cortical nature of the bone, and the long pedicle make it an ideal flap for reconstruction. The most significant feature of the fibula that differentiates it from other bone flaps is the ability to perform osteotomies to ensure a proper "fit" into the mandibular defect. This ensures maintenance of proper contour following reconstruction. The wedge osteotomy is commonly performed in this regard. However, the planning of the wedge is not without problems. The amount of the wedge and the angle of the wedge to be removed are difficult to plan. Numerous techniques have been described, including computer-based planning, model-assisted planning, and using prefabricated jigs. The purpose of this paper is to describe a simple and effective way of performing fibular osteotomies using a suture foil-based template, which is readily available in the operating room.