| Abstract: |
The fibula is the workhorse osseous flap for mandibular and maxillary reconstruction. The fibula may be harvested as a purely osseus flap or be combined with muscle, fascia, and skin to provide soft-tissue elements that may be required for reconstruction. The flap has an excellent pedicle with large-diameter vessels and a significantly sized skin paddle designed on the lateral leg, and the flexor hallucis longus muscle can be harvested in its entirety to provide excellent soft-tissue fill. The bone has both an intraosseous blood supply and a periosteal blood supply that allows for the ability to perform multiple osteotomies, which can be shaped to create the various contours of the mandible or the maxilla. The highly reliable fibula flap can be dissected simultaneously with the resection for trauma or disease in the head and neck, significantly decreasing operating time. This chapter describes the author’s surgical approach to harvesting the fibula osteo-myo-cutaneous flap. © Springer Nature Switzerland AG 2019. |
