title: The rare phenomenon of vascular pedicle ossification of free fibular flap in mandibular reconstruction.
abstract: Ossification of the vascular pedicle in the vascularized free fibular flap (VFFF) has been only previously described twice for jaw reconstruction. A case of severe trismus secondary to periosteal osteogenesis following VFFF for maxillary reconstruction, and four cases of ossification of the vascular pedicle in VFFF for maxillary and mandibular reconstruction have been respectively described. Etiology remains unclear, although presence of periosteum in continuity with bone seems to play a major role. Hormonal stimuli, stress over the bone, and corticosteroid therapy have been proposed as determinant factors, although no clear correlation has been already established. No histologic studies concerning the generation of new bone around the vascular pedicle in VFFF are nowadays present. We report a new case of vascular pedicle ossification of VFFF following mandibular reconstruction, this being the third report in the literature, and focus on histologic examination of the specimen.
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, Badajoz, Spain. raulmaxilo@gmail.com
authors.forename: Raúl
authors.initials: R
authors.lastname: González-García
authors.forename: Damián
authors.initials: D
authors.lastname: Manzano
authors.forename: Luis
authors.initials: L
authors.lastname: Ruiz-Laza
authors.forename: Carlos
authors.initials: C
authors.lastname: Moreno-García
authors.forename: Florencio
authors.initials: F
authors.lastname: Monje
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005360:Fibula / Q000098:blood supply / Q000637:transplantation; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008339:Mandibular Neoplasms / Q000601:surgery*; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D009999:Ossification, Heterotopic / Q000473:pathology*; D011183:Postoperative Complications / Q000473:pathology*; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply / Q000473:pathology*