Donor Site Morbidity And Function Following Vascularized Fibula Flap In Reconstruction Of Mandible:Cases Series Study (Three Cases Report)

Objective: This study is to establish donor-site morbidity and function evaluation system about vascularized fibula flap in reconstruction of mandible,and analyze 3 cases that have completed entire data collection,and to establish more evaluation of the lower limb function after the operation of vascularized fibula flap.A comprehensive evaluation system for patients to seek greater benefits,promote postoperative lower limb function rehabilitation,improve quality of life.Methods: To use BBS,AOFAS Ankle-Hindfoot Scale,Tecnobody static balance,Biodexsystem4 multi-joint velocity test system observed 3 cases who underwent fibula free flap reconstruction for head and neck defects in preoperative,postoperative 1 month,3 months,6 months and 12 months.Results: 1.The donor-site morbidity in 3 cases were observed at postoperative 1 month occurred great toe contracture,extension and dorsiflexion,abnormal pace,and left leg edema.Postoperative 6 months,left leg edema of two cases was not obvious improved,but other donor-site morbidity were improved.Postoperative 12 months,the dorsiflexion of the great toe was improved in 2 cases,and only one case the edema of the left lower extremity was improved,then the other morbidity had not changed.2.All cases in preoperative BBS scale were “Excellent”,then there was no obvious change from 1 month to 12 months after surgery.3.AOFAS Ankle-Hindfoot Scale was full in all cases before operation,decreased obvious at postoperative 1 month,remained Good in 2 cases and fair in 1 case,then 3 cases recovered in postoperative 3 months,1 case recovered to Excellent score.Other two cases were in Good score;two cases had achieved Excellent score at postoperative 6 months,and the score of case No.2 was the same as preoperative conditions;All cases recovered to excellent conditions at postoperative 12 months,which was not obvious different from that preoperative.4.In the Tecnobody balance test(S.r.l – PROKIN system),the lower extremity muscle balance and proprioceptive sensation of 3 patients decreased significant difference from preoperative and postoperative 1 month,and the index of the cases postoperative 3 months,6 months and 12 months were recovered.There was no significant difference in the total standard deviation of the body before and after operation.5.Biodexsystem4 isokinetic multi joint system test showed that the widest difference between in preoperative and postoperative 1 month.It was observed that the peak torque of 3 cases increased slowly at postoperative 6 months and improved obvious at postoperative 12 months compared with postoperative 1 month.In case no.2,the peak torque and time to peak torque and the average power exceeded the preoperative index at postoperative 6 months and 12 months.Conclusion: 1.The function of postoperative complications of vascularized fibula flap reconstruct mandibular on donor-site morbidity are acceptable.2.Tecnobody balance test,Biodexsystem4 Isokinetic multi joint system can be effectively and objectively used in the evaluation of lower extremity function in donor site.