Feasibility of the vascularized fibula bone graft for reconstruction of the mandible: a cadaveric study.

The aim of this study was to assess the feasibility of the unilateral single-barrel vascularized fibula bone graft (VFBG) for the restoration of mandibular defects. Eighty-one dry mandibles and fibulas were used. Each mandible was marked to measure the total mandible length (TML) and maximum defect length (MDL) for each type of defect (HCH, H, L, C, HC, LC, LCL, HCL; Boyd's classification and angle to angle). The fibula length (FL) was measured. The maximum vascularized fibula length (MVFL) was calculated as FL - 12 (cm). The feasibility of the unilateral single-barrel VFBG to reconstruct the mandible for each type of defect was determined from the MVFL:MDL ratio. Descriptive statistics, the Student's t-test, and Pearson's correlation coefficient were used for the statistical analysis; significance was set at P<0.05. Average TML, FL, and MVFL were 30.82±1.96cm, 31.75±2.23cm, and 19.75±2.23cm, respectively. The average MVFL:MDL ratios of HCH, LCL, and HCL were all <1. There was a significant positive correlation between TML and FL (r=0.48, P<0.01). The unilateral single-barrel VFBG alone is not feasible for the reconstruction of a near-total or total mandibular defect.

Proximal tibial bone graft: the volume of cancellous bone, and strength of decancellated tibias by the medial approach.

This study aimed to assess the volume of cancellous bone harvested by the medial approach from proximal tibia and compare the maximal compressive strength of decancellated tibias with intact tibias. Twelve cadavers were studied (11 male; 1 female). Cadavers with a history of bone disease and female cadavers over 60 years of age were excluded. Cancellous bone was taken from the right proximal tibia by the medial approach. Non-compressed and compressed cancellous bone volume was measured. Maximal compressive strength of decancellated tibias and intact tibias was measured and compared. The mean volume of bone harvested was 14.58±3.30 ml with the non-compress technique (range 10.5-19.5 ml) and 6.62±1.60 ml (range 4.0-9.2 ml) with the compress technique. There was no significant difference between the maximal compressive strength of the decancellated tibias and the intact tibias (P=0.085). Sufficient volume of cancellous bone for bone grafting in the oral maxillofacial surgery region can be harvested from the proximal tibia by the medial approach. The strength of decancellated tibias and intact tibias after harvesting cancellous bone graft were not different.