osteo radionecrosis mandible fibula reconstruction






Initial incision and oral fistula



After excision of necrotic tissue


Recipient vessel exposed


osteomyocutaneous fibula flap 


Patient in ICU


Flap status Day 1 after surgery
Vessel anastomosis to artery and vein  



muscle insetting on oral side

Flap insetting


 
Flap with final closure and glove drain

bleeding on flap and glove drain 

one month after surgery

Healed donor site.
At 3 weeks fully healed

Osteoradionecrosis of mandible is complication of radiotherapy for treatment of tumors. Best surgical management is total debridement and reconstruction with fibula flap with generous amount of skin and muscle.




Dr Adhishwar Sharma 
MBBS ,MS General surgery Mch Plastic surgery
Fellowship Head and Neck surgery
Fellowship Hand and microvascular surgery
8860650846,adhishwar7@gmail.com




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