A critical assessment of the fibula flap donor site.
The free fibula flap has become popular for mandibular reconstruction. The purpose of this study was to propose comprehensive functional assessments of the donor site.



Thirty free fibula flaps for mandible reconstruction were prospectively enrolled in the study. Objective assessments included isokinetic testing of the ankle joint, electromyographic examination of the superficial peroneal nerve (SPN), and preoperative and postoperative foot scans. The Patient and Observer Scar Assessment Scale (POSAS) was used to subjectively assess the donor site.



The isokinetic values of the donor side showed a significant decrease 1 year postoperatively. The results of the electromyographic test of the SPN were categorized as 3 types. The plantar center pressure shifted to the heel on the donor side 6 months postoperatively. The aesthetic outcome was satisfactory.



The functional parameters of the donor site indeed declined in our assessments. Further refinements in the surgical technique are needed to improve the donor site status. © 2016 Wiley Periodicals, Inc. Head Neck 39: 279-287, 2017.
Department of Oromaxillofacial - Head and Neck Surgery, School of Stomatology, China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China.|Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China.
Zhong-Fei
ZF
Xu
Department of Oromaxillofacial - Head and Neck Surgery, School of Stomatology, China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China.|Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China.
Shuang
S
Bai
Rehabilitation Center, Shengjing Hospital of China Medical University, Shenbei New District, Shenyang, Liaoning, People's Republic of China.
Zhi-Qiang
ZQ
Zhang
Department of Oromaxillofacial - Head and Neck Surgery, School of Stomatology, China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China.|Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China.
Wei-Yi
WY
Duan
Rehabilitation Center, Shengjing Hospital of China Medical University, Shenbei New District, Shenyang, Liaoning, People's Republic of China.
Zhi-Qiang
ZQ
Wang
Department of Oromaxillofacial - Head and Neck Surgery, School of Stomatology, China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China.|Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Heping District, Shenyang, Liaoning, People's Republic of China.
Chang-Fu
CF
Sun
D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002681:China; D015331:Cohort Studies; D004576:Electromyography / Q000379:methods; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply / Q000637:transplantation*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000473:pathology / Q000601:surgery; D063175:Mandibular Reconstruction / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000503:physiopathology*; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult
assessment; donor site; fibula flap; free flap; isokinetic test