title: Union and bone resorption of free fibular flaps in mandibular reconstruction.
abstract: BACKGROUND
  The purpose of this study was to evaluate bony union and resorption after free fibular flap reconstruction for mandibular reconstruction.
  
  
  METHODS
  A total of 112 patients with composite resection and reconstruction with a fibular free flap were included. Computed tomography scan images taken after the reconstruction and approximately 1 year postoperatively were assessed to evaluate union (n = 60) and bone resorption (n = 24) of the neomandible.
  
  
  RESULTS
  Most of the fibulas healed well (n = 34) and there was radiologic nonunion in 20% of the neomandibles at the time of evaluation (mean = 15 months). There was a statistically significant reduction in bone height in the native mandible (p = 0.02) and the anterior part of the fibular graft (p = 0.02).
  
  
  CONCLUSIONS
  There was a statistically significant reduction in mandibular and fibular graft height. However, the bone resorption was clinically minimal. Sufficient maintenance of height and good bony union support the use of free fibular flap in mandibular reconstruction.
authors.affiliation: Division of Plastic and Reconstructive Surgery, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: Tuija M
authors.initials: TM
authors.lastname: Yla-Kotola
authors.forename: Eric
authors.initials: E
authors.lastname: Bartlett
authors.forename: David P
authors.initials: DP
authors.lastname: Goldstein
authors.forename: Kathleen
authors.initials: K
authors.lastname: Armstrong
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Gilbert
authors.forename: Stefan O P
authors.initials: SO
authors.lastname: Hofer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001862:Bone Resorption; D005260:Female; D005360:Fibula / Q000503:physiopathology / Q000637:transplantation*; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006258:Head and Neck Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008334:Mandible / Q000503:physiopathology / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D008866:Microsurgery; D008875:Middle Aged; D016348:Osseointegration; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome