Use of fibula-free tissue transfer with preoperative 2-vessel runoff to the lower extremity.
OBJECTIVE
To present our experience with fibula-free tissue transfer in patients with documented 2-vessel runoff to the lower extremity on preoperative angiography.


METHODS
A case series of 16 patients with segmental mandibular defects reconstructed with a fibula-free flap by the senior author with 100% stenosis of the anterior or posterior tibial arteries were retrospectively reviewed for radiographic data and complications.


RESULTS
All flaps performed were successful, and there were no donor site complications. Angiography documented flow of contrast to the foot by a patent anterior or posterior tibial artery in all patients. Occlusive arteriosclerotic disease was identified in the anterior tibial artery in 10 patients and in the posterior tibial artery in 6 patients.


CONCLUSIONS
Using our specific criteria, we experienced no complications with the use of a fibula-free flap in extremities with 100% obstructive vascular disease in the anterior or posterior tibial artery. Preoperative angiography is indicated to select appropriate candidates for fibula-free tissue transfer with 2-vessel lower extremity runoff to avoid potential donor site ischemic complications.
Oxford
Lance
L
Department of Otolaryngology--Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, USA.
Ducic
Yadranko
Y
D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D005528:Foot / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007511:Ischemia / Q000517:prevention & control*; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D008334:Mandible / Q000601:surgery*; D011300:Preoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D014945:Wound Healing