Early outcomes of osteofascial versus osteocutaneous fibula free flap mandibular reconstruction

Abstract

AbstractBackgroundThis study compares early outcomes of osteofascial fibula free flap (OF‐FFF) with donor‐site primary closure and osteocutaneous (OC) FFF with donor‐site skin grafting in segmental mandibular reconstruction.MethodsA retrospective chart review of FFF mandibular reconstruction patients (2006–2022) divided into OF‐FFF and OC‐FFF groups. Clinical data, operative parameters, and early postoperative outcomes (≤ 90 days) were analyzed.ResultsThe study included 67 patients (39 OF‐FFF, 28 OC‐FFF). OF‐FFF had significantly lower donor‐site complications (12.8% vs. 53.6%, p < 0.001) and revision surgeries (7.7% vs. 35.7%, p = 0.004) compared to OC‐FFF. Recipient‐site (28.2% vs. 25%, p = 0.77) and flap (15.4% vs. 17.9%, p > 0.99) complications were comparable.ConclusionsOF‐FFF mandibular reconstruction with donor‐site primary closure is a safe and reliable technique associated with superior donor‐site and comparable flap and recipient‐site outcomes to OC‐FFF, thus may be considered as a viable alternative to OC‐FFF for selected patients.