A Simple and Cost Effective Template for Central Segment Reconstruction of Mandible with Free Fibula Flap

Purpose: A variety of templates are being used for mandible reconstruction with free flaps. We describe a simple and cost effective method using a 'K' wire template for the central segment reconstruction of the mandible with free fibula flap.

Materials And Methods: Over a period of 5 years from January 2005 to December 2009, there were a total of 386 mandible reconstructions with free fibula flaps of which 262 were central segment reconstructions. The number of osteotomies varied from 1 to 2 depending up on the length of the bone reconstructed. 'V' shaped closing wedge osteotomies were done and the segments were aligned with mini plates. In all the cases a 'K' wire was used in forming a template for the neo mandible from the resected specimen.

Results: The bone union was good in all the cases as determined by the orthopantomograms taken at the third month follow up. The most common complication was prognathism of the neo mandible.

Conclusion: 'K' wire template is a simple and cost effective device to design the shape of the neo mandible with less osteotomies and align the osteotomised bone segments in an angle that gives a near normal shape.