J Korean Assoc Oral Maxillofac Surg.  2006 Apr;32(2):138-141.

Long term evaluation of volume change in free vascularized fibular flap mandible reconstruction

• Kim YT
• Jeon SH
• Yeom HR
• Ahn KM
• Myoung H
• Hwang SJ
• Seo BM
• Choi JY
• Choung PH
• Kim MJ
• Lee JH

Abstract

INTRODUCTION
In recent years, vascularized, i.e., living bone grafts, have been widely applied in the field of oral and maxillofacial surgery, as a method of treatment of congenital or acquired non-unions, and a large defects in mandible. The vascularized fibular graft has been especially used for this purpose because of its shape and mechanical strength. The postoperative hypertrophy of grafted fibula is of particular interest to us. MATERIAL AND METHODS: This study was undertaken to determine the volume change(indirect methods) and radiographic appearance of a free vascularized fibular graft as it responds to the mechanical and physiologic features of its new environment. In order to elucidate the long term effect on fibular mass after mandibular reconstruction, change in various method of volume change was utilized as indirect measure of change in long-term.
RESULTS
The younger the patient, the more prominent and rapid the hypertrophy of the graft. the hypertrophy of the graft never exceeded the diameter of the recipient bone, except for callus enlargement after stress fracture of the grafted bone.
CONCLUSION
Etiologic explanations for this phenomenon have not been clarified in the previeous literature. some of the factors implicated include a periosteal reaction or new bone formation, as seen at the onset of bone union after a fracture in a child, a reaction to the mechanical loading on the graft and a reaction to the circulatory changes resulting from the grafting procedure.

MeSH Terms

Bony Callus
Child
Fibula
Fractures, Stress
Humans
Hypertrophy
Mandible*
Mandibular Reconstruction
Osteogenesis
Surgery, Oral
Transplants