泸州医学院学报2016，Vol.39Issue(5)：455-460,6.DOI:10.3969/j.issn.1000-2669.2016.05.015
两种血管化骨移植在下颌骨节段性缺损重建中的选择
Selection of fibular flap and iliac crest flap in the reconstruction of segmental mandibular defect
任黎蕾 1徐荣盛 2先德彬 2甘升远 2邵学磊 2张磊 2夏德林1
作者信息
- 1. 西南医科大学附属医院整形外科，四川泸州 646000
- 2. 西南医科大学附属口腔医院口腔颌面外科，四川泸州 646000
- 折叠
摘要
Abstract
Objective: To explore which methods, the fibular flap or iliac crest flap, is better for the reconstruction of different segmental mandibular defects. Methods: A retrospective review of 38 cases microvascular mandibular reconstruction performed in our department from June 2008 to June 2016 using 2 different techniques, 26 (68.4%) fibula flaps and 12 (31.6%) iliac crest flaps. Functional and aesthetic results, and complications of recipient and donor sites were evaluated according the clinic data. Based on the Schultz classification system, there were 10 cases of type I defect(a unilateral dentoalveolar defect not crossing the midline and not extending into the angle of the mandible), 18 cases of type II defect (a unilateral defect extending beyond the angle), 6 cases of type III defect (bilateral defect no involving the angles), and 4 cases of type IV defect (a bilateral defect with extension into at least one angle). The mean follow-up time was 16 months. ResuIts: In all cases, 12 iliac crest flaps and 24 fibular flaps survived well. There were 1 vascularized fibular flap failure caused by venous thrombosis and one case of skin island necrosis. Functional and aesthetic results showed that iliac crest flap was much better than fibular flap in reconstruction of type I and type II defects. The complication rate of iliac crest group is lower than that of fibular flap group in both recipient and donor sites. No obvious disorder of dornor sites occured in both groups. ConcIusions: Iliac crest and fibula free flaps are effective for restoring mandibular function by providing a rich bone stock. The iliac crest flap was more appropriate and may be selected in reconstruction of type I and type II defects without skin loss. The fibular flap should be chosen in other type segmental mandibular defect.关键词
骨移植/腓骨肌皮瓣/髂骨肌瓣/下颌骨缺损/显微外科Key words
Bone graft/Fibular flap/Iliac crest flap/Mandibular defect/Micro sugery分类
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任黎蕾,徐荣盛,先德彬,甘升远,邵学磊,张磊,夏德林..两种血管化骨移植在下颌骨节段性缺损重建中的选择[J].泸州医学院学报,2016,39(5):455-460,6.
