Evaluation of plate-related complications and efficacy in fibula free flap mandibular reconstruction

• Published in: The Journal of craniofacial surgery Vol. 25; no. 2; p. 397
• Main Authors: Zavattero, Emanuele, Fasolis, Massimo, Garzino-Demo, Paolo, Berrone, Sid, Ramieri, Guglielmo A
• Format: Journal Article
• Language: English
• Published: United States 01.03.2014
• Subjects: Adult; Aged; Bone Plates - adverse effects; Bone Transplantation - methods; Female; Fibula - transplantation; Free Tissue Flaps; Humans; Male; Mandibular Injuries - surgery; Mandibular Neoplasms - surgery; Mandibular Osteotomy - methods; Mandibular Reconstruction - methods; Middle Aged; Postoperative Complications; Retrospective Studies
• ISSN: 1536-3732
• DOI: 10.1097/SCS.0000000000000656

The objective of this study was to evaluate the incidence of plate-related complications after vascularized bony reconstruction of the mandible, comparing the plate type used. Between 2004 and December 2012, a total of 41 free osteocutaneous fibula flaps have been used in an equal number of patients for reconstruction of the mandible, at the Division of Maxillofacial surgery, San Giovanni Battista Hospital, University of Turin. Malignant pathology was the most common indication for segmental mandibulectomy.Patient outcomes were retrospectively evaluated with special attention to plate complications such as plate fracture, exposure, infection, and bony nonunion.The types of reconstruction plates used were mandible plates 2.0, locking plates 2.0, miniplates (<2.0), and locking 2.4 plates. Mandible plates 2.0 were used in 14 patients, locking plates 2.0 in 12 patients, and locking 2.4 plates in 4 patients. The most commonly used plates were miniplates, which were used in 86 patients.A total of 5 plate complications occurred after 41 procedures in an equal number of patients.Two complications occurred in patients receiving 2.0 mandible plates (2/14). One complication occurred in patients receiving 2.0 locking plates (1/12). Two complications occurred in patients receiving miniplates (2/86). In our experience, miniplates are not associated to a high rate of complications comparing to other plates. The advantage of these plates and the low rate of complications make them our first choice for mandibular reconstructions.