Surgical Anatomy for Fibular Free Flap Focusing on the Inferior Tibiofibular Syndesmotic System: A Cadaveric Study and Case Series of 3-Dimensional Prefabricate Cutting Guided Fibular Free Flap
2
Issued Date
2022-05-01
Resource Type
ISSN
10492275
eISSN
15363732
Scopus ID
2-s2.0-85131293161
Pubmed ID
35727650
Journal Title
Journal of Craniofacial Surgery
Volume
33
Issue
3
Start Page
951
End Page
955
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Craniofacial Surgery Vol.33 No.3 (2022) , 951-955
Suggested Citation
Ongsiriporn M., Chaikangwan I., Piyaman P., Khongchu N., Akaranuchat N., Yodrabum N. Surgical Anatomy for Fibular Free Flap Focusing on the Inferior Tibiofibular Syndesmotic System: A Cadaveric Study and Case Series of 3-Dimensional Prefabricate Cutting Guided Fibular Free Flap. Journal of Craniofacial Surgery Vol.33 No.3 (2022) , 951-955. 955. doi:10.1097/SCS.0000000000008323 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85890
Title
Surgical Anatomy for Fibular Free Flap Focusing on the Inferior Tibiofibular Syndesmotic System: A Cadaveric Study and Case Series of 3-Dimensional Prefabricate Cutting Guided Fibular Free Flap
Author's Affiliation
Other Contributor(s)
Abstract
AbstractEven though there are many options for mandibular reconstruction, a free fibula osteocutaneous flap is regarded as the most frequently used flap. Despite having some previous anatomical studies pertaining to syndesmotic ligaments, there is no study pointing out that surgical landmarks can be used while free fibula osteocutaneous flaps are performed and used for surgical landmarks in order to avoid syndesmotic ligament injuries. Therefore, this study investigates the characteristics and relationship between inferior syndesmotic ligaments and fibula in cadavers. A total of 140 legs were obtained from 83 embalmed cadavers as well as other soft ones, which were donated for the inferior tibiofibular syndes- motic system's study. Detailed dissection and measurement of each ligament's distance to the end of the fibula and lateral malleolus were performed. Distances from the distal end of the fibula to anterior inferior tibiofibular ligament, posterior inferior tibiofibular, and inferior transverse ligament, and the lower border of the interosseous membrane are 3.5 ± 0.4 cm, 3.4 ± 0.5 cm, 1.9 ± 0.4 cm, and 5 ± 1 cm (mean ± SD), respectively. Distance from the most distal part of the fibula to lateral malleolus is 1.6 ± 0.4 cm (mean ± SD). Thus, the remaining distance of the fibular should be left at least 4 cm without disrupting the syndesmotic ligament complex. It is argued that the lateral malleolus can be applied as a surgical landmark while harvesting fibula.