带血管蒂腓骨组织瓣游离移植修复下颌骨缺损的临床研究
The Utility of Vascularized Free Fibula Flap in Mandibular Reconstruction: A Clinical Report of 25 Cases
作者：佟猛,李龙江,温玉明,付风华,唐休发,王晓毅
Author：TongMeng, Li Longjiang, Wen Yuming, et al
收稿日期：2002-10-25 年卷（期）页码：2002,20(05):340-
期刊名称：华西口腔医学杂志
Journal Name：West China Journal of Stomatology
关键字：腓骨瓣,游离移植,下颌骨重建,
Key words：fibula,free fibula flap,mandibular reconstruction,
基金项目：
中文摘要
目的:评价带血管蒂腓骨组织瓣游离移植修复下颌骨缺损的临床应用价值。方法:对25例患者用腓骨瓣游离移植修复下颌骨缺损。手术采取血管吻合、坚固内固定方法恢复下颌骨形态及完整性。其中22例患者为单纯腓骨瓣移植,3例患者为携带肌皮瓣或皮瓣的腓骨瓣移植,3例患者还同期植入种植体共5枚。结果:25例患者平均随访917个月,成功率为96%。3个患者的5枚种植体均达到良好的骨整合效果,并已行上部义齿的修复。62% 的患者可正常进食,余38%的患者可进软食。96%的患者面部外形的恢复达满意或较为满意。所有患者均能正常行走,无1例出现踝关节不稳定。结论:带血管蒂的游离腓骨组织瓣具有众多其它自体骨组织瓣不可比拟的优点, 是下颌骨缺损修复重建的最佳方法之一。
英文摘要
Objective:The purpose of this studywas to evaluate the advantages and disadvantages of vascularized free fibula flap as a new method for mandibular reconstruction.Methods:25 cases (17 male to 8 female)who have received mandibular reconstructionwith free vascularized fibular flaps in ourhospitalwere studied retrospectively. The average length of the fibula grafts is1010 cm (range from 515 to 16 cm). 3 cases received primary insertion of osteointegrated dental implants into the free fibula flap, and all these 5 implants survived.Results:All flaps except 1 were viable. 62% of the cases took normal diet postoperatively, and the remainder took soft diet as well. All patients spoke clearly. No ankle unstability was reported. And the aesthetic assessments in all patients were good or fair.Conclusion:Vascularized free fibular flap takes its distinct advantages to other autogeneous free bone flaps and is confirmed to be one of the optimal methods for mandible reconstruction by our study.
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