oromandibular defect with free fibula flap

defect after resection of tumour

assessment of defect

Fibula bone placed for plating


after final closure 


Good bleed from skin paddle from scratching 

 Fibula osteocutanous flap is used in microvascular surgery for complex oromandibular defect. Around  25 cm  fibula is available for reconstruction. In this case 7 cm strut was used for reconstructing ramus of mandible. Vascular pedicle of mandible was anastomosed vessel in neck, usually facial artery is used as arterial source . Branches of IJV are used for venous outflow ,sometimes EJV is also used when feasible. Skin paddle is used for lining inner mucosa and for skin defects. Orientation of fibula bone is also important for correct alignment of bone.  Post op flap is monitored for 5 days for anastomosis patency and tab ecosprin is given for 30 days.

Dental rehabilitation can be carried out once radiotherapy and other adjuvant treatment is done.



Dr Adhishwar Sharma

MBBS,MS PGI Chd, Mch Plastic surgery

Fellowship in microvascular surgery

8860650846

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