Pediatric mandibular reconstruction using a vascularized fibula flap

Background. The purpose of this study was to address questions concerning the functional outcome following mandibular reconstruction with vascularized fibula flap in skeletally immature children. Methods. Eleven patients 14 years old or younger who underwent mandibular reconstruction using a free fibula flap were evaluated. Results. The mean follow-up was 3.4 years. One flap loss occurred and required a second fibula flap. Panorex radiographs showed good bone union and growth in all patients. Functional outcomes were normal according to age in all patients. Two patients had long-term malocclusion. No patients had to undergo corrective orthognathic surgery. Donor-site morbidities consisted of great toe flexion contracture (n = 4) and a valgus deformity (n = 1). All patients had a normal gait, and there were no discrepancies in leg length. Conclusion. A mandible reconstructed using a vascularized fibula flap appears to grow accordingly as the child grows, with minimal disturbance to the growth pattern of the midface.