eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery
Tissue Transfer, Fibula: Workup
Updated: Mar 18, 2009
Workup
Laboratory Studies
- Laboratory studies based on patient history
- Coagulation panel
Imaging Studies
- Chest radiography to assess chronic obstructive pulmonary disease and metastasis
- CT scanning
- CT scan findings augment the physical examination findings to assess the anticipated defect size.
- Consider the size and orientation of the anticipated soft-tissue defect.
- 3-Dimensional modeling may facilitate reconstruction.1
Other Tests
- The role of preoperative Doppler examination or angiographic imaging to evaluate the vascular anatomy of the leg is disputed (see Future and Controversies).
- Magnetic resonance angiography (MRA) has been used to assess the vascular supply of the leg. Expense has relegated its use to a small number of centers.
- Physical examination remains the primary method of evaluation. Abnormal results following physical examination is often enough to mandate a different flap.
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References
Thankappan K, Trivedi NP, Subash P, et al. Three-dimensional computed tomography-based contouring of a free fibula bone graft for mandibular reconstruction. J Oral Maxillofac Surg. Oct 2008;66(10):2185-92. [Medline].
Disa JJ, Cordeiro PG. The current role of preoperative arteriography in free fibula flaps. Plast Reconstr Surg. Sep 1998;102(4):1083-8. [Medline].
Futran ND, Wadsworth JT, Villaret D, Farwell DG. Midface reconstruction with the fibula free flap. Arch Otolaryngol Head Neck Surg. Feb 2002;128(2):161-6. [Medline].
Garrett A, Ducic Y, Athre RS, Motley T, Carpenter B. Evaluation of fibula free flap donor site morbidity. Am J Otolaryngol. Jan-Feb 2006;27(1):29-32. [Medline].
Ghaheri BA, Kim JH, Wax MK. Second osteocutaneous fibular free flaps for head and neck defects. Laryngoscope. Jun 2005;115(6):983-6. [Medline].
Hidalgo DA. Fibula free flap mandibular reconstruction. Clin Plast Surg. Jan 1994;21(1):25-35. [Medline].
Shindo M, Fong BP, Funk GF, Karnell LH. The fibula osteocutaneous flap in head and neck reconstruction: a critical evaluation of donor site morbidity. Arch Otolaryngol Head Neck Surg. Dec 2000;126(12):1467-72. [Medline].
Urken ML, Cheney ML, Sullivan MJ. Fibula free flaps. Atlas of Regional and Free Flaps for Head and Neck Reconstruction. New. York, NY: Raven Press; 1995.
Wax MK, Winslow CP, Hansen J, et al. A retrospective analysis of temporomandibular joint reconstruction with free fibula microvascular flap. Laryngoscope. Jun 2000;110(6):977-81. [Medline].
Woerdeman LA, Chaplin BJ, Griffioen FM, Bos KE. Sensate osteocutaneous fibula flap: anatomic study of the innervation pattern of the skin flap. Head Neck. Jul 1998;20(4):310-4. [Medline].
Further Reading
Keywords
fibula tissue transfer, fibula free flap, fibula, tissue transfer, tissue loss, osteocutaneous free tissue transfer, maxillary defects, mandible reconstruction
Workup: Tissue Transfer, Fibula