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首页> 外文期刊>Journal of plastic, reconstructive & aesthetic surgery: JPRAS >Double-barrel vascularised fibula graft in mandibular reconstruction: A 10-year experience with an algorithm
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Double-barrel vascularised fibula graft in mandibular reconstruction: A 10-year experience with an algorithm

机译：双管血管化腓骨移植在下颌骨重建中的应用：10年的算法经验

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Background: This retrospective study aims to report an algorithm to assist surgeons in selecting different modes of the double-barrel vascularised fibula graft for mandibular reconstruction. Methods: A total of 45 patients who underwent reconstruction of mandibular defects with different modes of the double-barrel vascularised fibula graft were reviewed. Our algorithm for deciding on any one of the different modes for different mandibular defects is influenced by factors including history of radiotherapy, the length of mandibular body defect and the need to preserve the inferior mandibular border. Post-operative functional outcomes included diet type and speech, and aesthetic results gained at post-operative 2 years. Patients with implant-borne prosthetic teeth underwent assessment of their masticatory function. Results: There were four modes of mandibular reconstruction according to our algorithm, which included double-barrel vascularised fibula graft (n = 21), partial double-barrel fibula graft (n = 11), condylar prosthesis in combination with partial/double-barrel fibula graft (n = 11), and double-barrel fibula onlay graft (n = 2). Flap survival in all patients was 97.78%. Good occlusion, bony unions and wound closures were observed in 44 patients. Eleven patients received dental implantation in the transplanted fibula at post-operative 9-18th months. One patient wore removal partial dentures. For 11 patients with implant-borne prosthetic teeth, the average post-operative ipsilateral occlusal force was 41.5 ?? 17.7% of the contralateral force. Good functional and aesthetic results were achieved in 38 patients with more than 2 years of follow-up, including regular diet, normal speech and excellent or good appearance, especially for patients with dental rehabilitation. Conclusion: Good aesthetic and functional results can be achieved after dental rehabilitation by following our algorithm when choosing the different modes of double-barrel vascularised fibula graft for mandibular reconstruction. ? 2012 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.
机译：背景：这项回顾性研究旨在报告一种算法，以协助外科医生选择不同模式的双管血管化腓骨移植物进行下颌骨重建。方法：回顾性分析45例不同类型双管血管化腓骨移植修复下颌骨缺损的患者。我们用于确定下颌骨不同缺陷的任何一种模式的算法受以下因素影响，这些因素包括放射治疗的历史，下颌骨缺损的长度以及需要保留下颌骨下缘的需要。术后功能结局包括饮食类型和言语，以及术后2年获得的美学效果。植入物义齿的患者接受咀嚼功能评估。结果：根据我们的算法，下颌重建有四种模式，包括双管血管化腓骨移植（n = 21），部分双管腓骨移植（n = 11），con突假体与部分/双管联合腓骨移植（n = 11）和双管腓骨覆盖移植（n = 2）。所有患者的皮瓣存活率为97.78％。在44例患者中观察到良好的闭塞，骨性结合和伤口闭合。术后9-18个月，有11例患者在移植的腓骨进行了牙科植入。一名患者摘除局部义齿。对于11颗植入物修复牙齿的患者，平均术后同侧咬合力为41.5 ??。对侧力的17.7％。 38例接受2年以上随访的患者获得了良好的功能和美学效果，包括常规饮食，正常言语和出色或良好的外表，尤其是对于牙科康复患者。结论：选择不同方式的双管血管化腓骨移植物进行下颌骨重建时，遵循我们的算法，可以在牙科康复后获得良好的美学和功能效果。 ？ 2012年由Elsevier Ltd代表英国整形，修复和美学外科医生协会出版。版权所有。

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