RESUMO
Objective:This article discusses a saved-time and strength method with the vascularized fibula free combined flap for instant mandible retained condyle and corresponding soft tissue reconstruction.This method is based on our clinical experience.Methods: 8 patients suffering from combined mandibular defect because of series of reasons were chosen.Combined vascularized fibula free flap for instant mandible retained condyle and corresponding soft tissue reconstruction was performed.The skin paddle(skin island) of the osteocutanous flap was based on the perforators and used to repair mucosal or skin defect,or as an external"monitor",which was shuttle-shaped.The average value of the fibula length is 8.5cm and the average value of surface area of skin paddle(skin island) is 6.5cm?3.5cm.The fibulas were shaped and fixed with long prefabricated titanium plate on 3 patients and with segmented mini-plate/16-holed titanium plate on the rest patients.Results: All flaps survived well without failure except one.All patients had well-incisions,good occlusion,mandibular normal activity and symmetric appearance.But the lasting time of using long prefabricated titanium plate is longer than that of using segmented mini-plate/16-holed titanium plate.Conclusions:Combined vascularized fibula free flap can cut into 2~3 segments based on the mandibular shape and occlusion,shaping and fixation using segmented mini-plate/16-holed titanium plate make the procedure easier and safer.It is advised that the fixation sequence is firstly condyle,secondly the angle and next the mental foreman area and the connection between the fibula and the chin.