A critical assessment of the fibula flap donor site

Head Neck. 2017 Feb;39(2):279-287. doi: 10.1002/hed.24581. Epub 2016 Sep 12.

Abstract

Background: The free fibula flap has become popular for mandibular reconstruction. The purpose of this study was to propose comprehensive functional assessments of the donor site.

Methods: Thirty free fibula flaps for mandible reconstruction were prospectively enrolled in the study. Objective assessments included isokinetic testing of the ankle joint, electromyographic examination of the superficial peroneal nerve (SPN), and preoperative and postoperative foot scans. The Patient and Observer Scar Assessment Scale (POSAS) was used to subjectively assess the donor site.

Results: The isokinetic values of the donor side showed a significant decrease 1 year postoperatively. The results of the electromyographic test of the SPN were categorized as 3 types. The plantar center pressure shifted to the heel on the donor side 6 months postoperatively. The aesthetic outcome was satisfactory.

Conclusion: The functional parameters of the donor site indeed declined in our assessments. Further refinements in the surgical technique are needed to improve the donor site status. © 2016 Wiley Periodicals, Inc. Head Neck 39: 279-287, 2017.

Keywords: assessment; donor site; fibula flap; free flap; isokinetic test.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Bone Transplantation / adverse effects
  • Bone Transplantation / methods*
  • China
  • Cohort Studies
  • Electromyography / methods
  • Female
  • Fibula / blood supply
  • Fibula / transplantation*
  • Follow-Up Studies
  • Free Tissue Flaps / blood supply
  • Free Tissue Flaps / transplantation*
  • Hospitals, University
  • Humans
  • Male
  • Mandibular Neoplasms / pathology
  • Mandibular Neoplasms / surgery
  • Mandibular Reconstruction / adverse effects
  • Mandibular Reconstruction / methods*
  • Middle Aged
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Tissue and Organ Harvesting / methods
  • Transplant Donor Site / physiopathology*
  • Wound Healing / physiology*
  • Young Adult