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J Craniomaxillofac Surg. 2018 Sep;46(9):1674-1678. doi: 10.1016/j.jcms.2018.06.019. Epub 2018 Jul 5.

Fibula free flap pedicle ossification: Experience of two centres and a review of the literature.

Author information

1
Maxillo-Facial Surgery and Odontostomatology Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Università degli Studi di Milano-Bicocca, Milano, Italy. Electronic address: camillabaserga@gmail.com.
2
Maxillo-Facial Surgery and Odontostomatology Unit, University Hospital of Sassari, Sassari, Italy.
3
Maxillo-Facial Surgery and Odontostomatology Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy.
4
Maxillo-Facial Surgery and Odontostomatology Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.

Abstract

PURPOSE:

The osteogenic potential of vascularized periosteum has been described in a few cases in the literature, and many different factors have been pointed out as plausible. Our aim was to review the literature in order to give a complete overview of this topic and to report on our clinical experience.

PATIENTS & METHODS:

Our experience includes three patients who underwent maxillectomy and FFF reconstruction. A progressive reduction in mouth opening was noticed in the months after surgery, and CT scans showed calcified tissue around the pedicle. Surgical revisions were performed. No recurrences were noticed. A full systematic literature review was conducted, including studies published on or before September 2016.

RESULTS:

Clinically, free flap pedicle ossification is presented as trismus, hard swelling, and severe pain during movements, although the diagnosis is scarce and often fortuitous. From January 2010 to January 2016 we performed 68 FFF reconstructions, and the incidence of FFF pedicle ossification in our experience was 4.4%.

CONCLUSION:

Ossification of FFF pedicle is uncommon, but when it occurs, it has dramatic clinical consequences. Follow-up CT scan can be useful in diagnosis. In our experience, surgery should be performed only when the patient is symptomatic.

KEYWORDS:

Fibula free flap; Free flap pedicle ossification; Pedicle ossification

PMID:
30075903
DOI:
10.1016/j.jcms.2018.06.019
[Indexed for MEDLINE]

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