[Role of fibula in replacement of mandible].
The mandible and the fibula are two totally different bones of the human skeleton. The fibula is a long straight bone of the lower leg playing secondary role compared with the tibia. The mandible, or jaw bone, is the only facial bone that moves and has complex spatial structure. The blood supply of the mandible is mainly endosteal, the inferior mandibular artery, which is one of the more important branch of the maxillary artery is responsible for its arterial supply. The fibula shows the uniform pattern of periosteal blood supply receiving many small branches from the peroneal artery, and having only weak endosteal supply. The mandible articulates with the two temporal bone, and the fibula articulates with the tibia at the tibio-fibular syndesmosis and distally has a role in the formation of the lateral talocrural joint. The demand for mandibular replacement was approved simultaneously with the appearance of ablative surgery for head and neck cancer. As knowledge of physiology and pharmacology expanded in the twentieth century, major developments in the field of anesthesiology and surgery opened new windows of ablative cancer surgery that were previously unimaginable. Soldiers were badly wounded with extensive soft-tissue defects during World Wars and in certain countries, high gun ownership rates show substantial correlations with gun-related injuries. Health care development and the invention and wide-spread use of antibiotics revolutionized medical treatment and improved recovery rates and reduced mortality following trauma. Total or partial loss of the mandible without reconstruction incurs serious functional and psychological morbidity for patients. Prior to the development of advanced reconstruction options for mandibular defects, they were left with terrible cosmetic deformities. Throughout the second half of the twentieth century, various attempts were made to replace the mandible but the major breakthrough was the appearance of the microvascular technique at the end of the seventies and the beginning of the eighties.
Országos Onkológiai Intézet Fej-nyak-, Allcsont- és Rekonstrukciós Sebészeti Osztály, Budapest. fulop.m@oncol.hu
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Fülöp
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Branzaniuc
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Kásler
D016025:Bone Transplantation / Q000379:methods*; D004954:Esthetics; D005360:Fibula / Q000637:transplantation*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008334:Mandible / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D016896:Treatment Outcome