American Association of Plastic Surgeons Meeting 2022

Mini-Plate Versus Reconstruction Bar Osseous Fixation for Oncologic Reconstruction with Free Fibula Flaps: A Single Center Experience
Zack Cohen, Francis D. Graziano, Meghana G. Shamsunder, Farooq Shahzad, Jay O. Boyle, Marc A. Cohen, Evan Matros, Jonas A. Nelson, Robert J. Allen Jr., Department of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY

Purpose

•To examine complication rates between mini- plate (MP) and reconstruction bar (RB) fixation of free fibula flaps (FFF) in the setting of segmental mandibular defects

•We hypothesized a lack of inherent rigid fixation with MPs would lead to higher rates of hardware exposure

Methods

•Retrospective review of all patients who underwent FFF reconstruction after mandibulectomy from 2015-2021

•Primary outcomes of interest: perioperative flap-related complications/infections as well as long-term osteoradionecrosis and hardware failure/exposure

•Patients were stratified into two groups: short-term (<90 days) and long-term (>90 days) complications (in relation to date of surgery)

Results

•96 patients met inclusion criteria (RB=63, MP=33)

•Patients were similar with respect to age, diabetes, CAD/PVD, smoking status, and operative characteristics

•The mean follow-up period was 17.24 months

•Adjuvant radiation was administered to 60.6% and 54% of patients in the MP and RB cohorts, respectively.

•Previous head and neck surgery was performed in 22 RB and 10 MP patients

•In patients whose first complication occurred after 90 days, MPs had significantly higher rates of hardware exposure (p=0.046)

Conclusions

•In patients with late complications, MPs have a higher risk of long-term hardware exposure

•Future studies are needed to assess the effects of fixation on patient reported outcomes (PROs) and quality of life measures in this population

American Association of Plastic Surgeons Meeting 2022

Mini-Plate Versus Reconstruction Bar Fixation For Oncologic Reconstruction With Free Fibula Flaps: A Single Center Experience

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