title: [Condylar remodelling after temporomandibular joint reconstruction with fibula free flap].
abstract: OBJECTIVE
  Mandibular reconstructions with fibula free flap are commonly used in maxillo-facial surgery; termino-lateral mandibulectomy with reconstruction of the ramus and condylar unit is seldom used. Consequences on the temporomandibular joint remain unclear, and the type of reconstruction is still subject to controversy.
  
  
  METHODS
  Six patients were followed after terminal mandibulectomy, reconstructed with fibular free flap. Evaluations of the results were made on functional and radiological criteria.
  
  
  RESULTS
  No patient presented functional disturbances due to reconstruction. Remodeling of the neocondyle extremity was weak in adults but important in children, with modification of morphology and architecture of the condyle in children.
  
  
  CONCLUSIONS
  Preservation of the disc is recommended. Many techniques are described to improve congruence, preservation and remodeling of the free extremity of the fibula flap. All give similar results. It seems that the real determinant factors on the quality of the result are age, presence of the disc or not, previous surgery performed, with or without radiotherapy.
authors: Service de chirurgie maxillo-faciale, plastique et reconstructrice, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex 9, France. Electronic address: gilliotbenedicte@aol.com.
authors: B
authors: B
authors: Gilliot
authors: Service de chirurgie maxillo-faciale, plastique et reconstructrice, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex 9, France.
authors: J
authors: J
authors: Siefert
authors: Service de chirurgie maxillo-faciale, plastique et reconstructrice, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex 9, France.
authors: A
authors: A
authors: Caillot
authors: Service de chirurgie maxillo-faciale, plastique et reconstructrice, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex 9, France.
authors: E
authors: E
authors: Soubeyrand
authors: Service de chirurgie maxillo-faciale, plastique et reconstructrice, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex 9, France.
authors: J-F
authors: JF
authors: Compère
authors: Service de chirurgie maxillo-faciale, plastique et reconstructrice, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex 9, France.
authors: H
authors: H
authors: Bénateau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016723:Bone Remodeling; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005360:Fibula / Q000473:pathology / Q000637:transplantation*; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008334:Mandible / Q000502:physiology / Q000601:surgery; D008335:Mandibular Condyle / Q000502:physiology / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D013704:Temporomandibular Joint / Q000473:pathology / Q000601:surgery*
keywords: Condyle; Fibula; Reconstruction