Osteotomy to treat malocclusion following reconstruction of the mandible with the free fibula flap.

Abstract

Malocclusion may result after free fibula flap reconstruction of the mandible, because of inadequate positioning of the temporomandibular joint, inaccurate contouring of the reconstruction plate, or subsequent fracture of a miniplate. Factors that alter the vascularity of the transplanted fibula may also result in a delayed presentation of malocclusion. Seven cases are presented, in which primary surgical treatment consisted of segmental mandibulectomy and reconstruction with a free fibula osteoseptocutaneous flap. Fixation was achieved with a reconstruction plate in five cases and a miniplate in two cases. Malocclusion was corrected with an osteotomy performed at the junction of the fibula and the native mandible. The new osteotomy sites were fixed with miniplates and maintained with intermaxillary fixation. Complete bony union was achieved at the osteotomy sites. The correction of malocclusion was successful in all cases, and all patients have resumed a normal diet. This report demonstrates that osteotomy and realignment of the mandible are effective for the secondary correction of malocclusion after mandibular reconstruction with the free fibula osteoseptocutaneous flap.

• Authors: Yang-Ming Chang, Jagdeep S Chana, Fu-Chan Wei, Chi-Ying Tsai, Samuel H T Chen
• Journal: Plastic and reconstructive surgery (Plast Reconstr Surg) Vol. 112 Issue 1 Pg. 31-6 (Jul 2003) ISSN: 0032-1052 [Print] United States
• PMID: 12832873 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Aged
• Bone Transplantation
• Fibula
• Humans
• Male
• Malocclusion (etiology, surgery)
• Mandible (surgery)
• Mandibular Diseases (surgery)
• Mandibular Neoplasms (surgery)
• Middle Aged
• Osteoradionecrosis (surgery)
• Osteotomy
• Plastic Surgery Procedures (adverse effects)
• Retrospective Studies
• Surgical Flaps