Clinical and Radiological Assessment of Post-Surgical Sequelae in Donor Site after Microsurgical Fibula Free Flap

Abstract

Objectives: Fibula free flap is commonly used in mandibular reconstruction. It is globally accepted that the morbidity in the donor site is minimal. The aim of this study was to assess the clinical and radiological morbidity of the donor-site after microsurgical fibula free flap. Study design: A retrospective case series study was performed for clinical and radiological assessment of the donor-site in 18 patients who underwent oromandibular reconstruction with fibula free flap between the years 2008 and 2018 in Hospital Clínico San Carlos. Post-operative complications, and clinical and radiological variables were evaluated. Results: The most prevalent clinical variables were cold intolerance in 11 patients (61.11%), motor weakness in 10 patients (55.56%), gait disorders in 9 patients (50%) and sensory deficit in 9 patients (50%). The main radiological complications were: knee arthrosis in 17 patients (94.44%), remaining fibula distal ends osteoporosis in 14 patients (77.78%) and ankle arthrosis in 13 patients (77.78%). A statistically significant relation was found between distal fibula remnant length < 80 mm and: Gait disorders, instability, motor weakness and distal fibula remnant osteoporosis. Conclusions: It is difficult to assess the morbidity in the donor-site due to subjectivity and inter individual variability of symptoms. The results showed a low complication rate, however, long term effects may include an alteration in the lower limb functionality.