Workup
Laboratory Studies
See the list below:
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Laboratory studies based on patient history
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Coagulation panel
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Imaging Studies
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Chest radiography to assess chronic obstructive pulmonary disease and metastasis
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Other Tests
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The role of preoperative Doppler examination or angiographic imaging to evaluate the vascular anatomy of the leg is disputed (see Future and Controversies).
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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. [8]
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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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Media Gallery
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Complex defect involving anterior mandibular arch.
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The fibula free flap is well suited for anterior mandibular arch defects. The complete arch can be rebuilt following shaping of the bone.
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Patient with plate exposure after reconstruction of a mandibular defect without the use of an osteocutaneous flap.
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Angiogram showing poor candidate for fibular flap. Solid arrow: anterior tibial artery. Hollow arrow: peroneal artery. Short arrow: plantar artery from posterior tibial artery.
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Patient with poor circulation to the lower leg following fibula free flap harvesting.
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Fibula harvest following osteotomies. After complete dissection of the pedicle and preparation of the recipient site, the pedicle is transected.
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Following harvest, the proximal bone is trimmed and osteotomies are performed if necessary. The reconstruction plate is used as a template for shaping the bone.
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Donor site closure.
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Patient with osseointegrated implants in flap.
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