Background and objectives: Reconstruction of jaw defects secondary to resections represents a surgical challenge. Mandibulectomy associated to soft tissues is usually required, bringing different degrees of esthetic and functional alterations. Our surgical experience in mandibular reconstruction using free fibula flap is presented.

Methods: Retrospective analysis of patients who underwent mandibulectomy and reconstruction with free vascularized fibula flap between 2007 and 2012 in our hospital.

Results: The sample consisted of 9 patients, 7 males (77.7%). The technique used was total resection of mandibular neoplasia followed by reconstruction with free fibula flap. In 3 patients an adequate functional result was achieved. 5 patients suffered exposition and graft loss.The fibula free flap was the most rational choice because of its features. It is indicated in large mandibular defects reconstruction because it has a compatible bone length and can be modeled with multiple osteotomies, plates can be easily adapted and it has a low morbidity.

Conclusions: Free fibula flap is a surgical alternative, with good functional and esthetics results, with low morbidity in patients undergoing mandibulectomy. The learning curve has been slow and requires a close and constant team of work. We expose and share our failures.

Key Words : fibula; reconstruction; cancer; free flap