Release of extra-articular ankylosis by coronoidectomy and insertion of a free abdominal flap: case report.
BACKGROUND
It is generally agreed that an effective treatment for extra-articular ankylosis may be coronoidectomy and excision of scar tissue. But these conventional procedures have shown a high rate of recurrence of ankylosis due to heterotopic bone and fibrous tissue formation. OBJECTIVE AND PATIENT: We report a case in whom a coronoid osteotomy and insertion of a free abdominal flap was used to treat ankylosis of the mandible following radiotherapy for maxillary cancer.


RESULTS
This procedure prevented recurrence of ankylosis by heterotopic bone and fibrous tissue formation. In addition, this flap reduced the risk of postoperative infection and promoted primary healing.


CONCLUSIONS
The procedure, coronoidectomy and insertion of a free flap, was successful because the well-vascularized musculocutaneous flap occupied the dead space, and replaced the shortage of oral mucosa consequently inhibiting the recurrence of extra-articular ankylosis.
Fujioka
M
M
Department of Plastic and Reconstructive Surgery, Miyazaki Social Insurance Hospital, Japan. m-fujioka@mwc.biglobe.ne.jp
Daian
T
T
Murakami
R
R
Makino
K
K
D000368:Aged; D000844:Ankylosis / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery; D002921:Cicatrix / Q000601:surgery; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D005887:Gingival Neoplasms / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008336:Mandibular Diseases / Q000601:surgery*; D008406:Masseter Muscle / Q000601:surgery; D008441:Maxillary Neoplasms / Q000532:radiotherapy / Q000601:surgery; D009135:Muscular Diseases / Q000601:surgery; D009999:Ossification, Heterotopic / Q000517:prevention & control; D010027:Osteotomy / Q000379:methods; D011832:Radiation Injuries / Q000601:surgery; D017568:Rectus Abdominis / Q000637:transplantation*; D012008:Recurrence; D016038:Skin Transplantation; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000517:prevention & control; D014945:Wound Healing