The vascularized fibular flap for mandibular reconstruction.

Vascularized fibular bone grafts have advantages over other bone grafts in the restoration of the contour and function of defective mandibles. The fibular graft can be tailored to fit even major mandibular defects; in combination with preformed temporomandibular joint prostheses total mandibular reconstruction can be performed in a single procedure. The fibular transplant is considered ideal for the insertion of implants to support dental suprastructures to obtain maximal oral rehabilitation. We have used fibular grafts in eight cases for primary or secondary reconstruction of a variety of mandibular defects resulting from cancer, chronic osteomyelitis or gunshot injuries. The results have been most encouraging with respect to function and cosmetic appearance. There have been no transplant failures and minimal donor site complications.