Ninety-eight patients with segmental mandible defect were reconstructed with vascularized free fibular flap, in which 63 were males and 35 females, the age ranging from 16 to 76 years, and the mean age 39.0. Ninety-three cases were immediately reconstructed, and five cases were secondarily reconstructed. Sixty-seven free fibular flaps and 31 fibular osteomyocutaneous flaps were used. The length of harvested fibula was ranging from 6 cm to 21 cm with the average of 13.91 cm. The fibula was transplanted in one piece or cut into two or more pieces according to the shape of the mandible, with the maximum of up to 6 pieces. Bony segments were fixed by miniplates and/or reconstruction plates. Five cases of double barrel fibular flaps were used with immediate dental implant. Six double skin paddle flaps were used for reconstructing the oromandibular through-and-through defects. All donor sites were closed by normal approximation except in one case, which was closed by split skin graft. The postoperative course was smoothly in 93 cases. Vascular crisis was appeared in 5 cases, 3 being rescued and 2 failed. The success rate was 97.96%. The patients regained good or fair or acceptable shape and function. It is concluded that free vascularized fibular flap reflects good functional and esthetic results with high degree of consistency and acceptable level of complications, and is the first choice for mandibular defect reconstruction.

Conflict of interest: None declared.