Step-by-step mandibular reconstruction with free fibula flap modelling

The functional and aesthetic outcomes after segmental mandibular resection are closely related to the technique used during mandibular reconstruction with bone graft. The fibula free flap approach allows the possibility of using bone with/without skin for restoring the defect. Here, we aimed to establish the preplating technique for oromandibular reconstruction in a step-by-step fashion, based on 41 patients. The surgical technique is expounded in 8-10 steps. Preplating, plate removal, resection, replating, template modelling, contouring and fixation of the fibula represent the key points of the procedure. In this report, we show that the preplating and template modelling method is easy, does not incur extra costs and can be successfully used for mandibular reconstruction with bone graft. Functional and aesthetic results confirm the feasibility and reproducibility of the technique.