{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:38:21Z","timestamp":1747150701724,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Reconstruction after maxillofacial trauma is extremely challenging. During the past several decades, the chimeric fibular\u2010free flap has emerged as a leading reconstructive option for head and neck compound defects. This report describes a unique case of total mandibular reconstruction using a double\u2010paddle osteocutaneous fibular free flap after facial traumatic injury. A 45\u2010year\u2010old man presented a severe maxillofacial trauma with complete mandibular avulsion. The shortest segment of a 24\u2010cm fibular flap was used to reconstruct the symphysis while the longest segments were placed to rebuild the mandibular body. Microvascular anastomoses were performed with the external jugular vein and facial artery. The distal skin island (10\u2009\u00d7\u20095\u2009cm) was sutured to cover the endo\u2010oral defect while the proximal one (12\u2009\u00d7\u20096\u2009cm) to restore the external tissues continuity of the facial lower third. The postoperative course was uneventful. One year after flap reconstruction, a first commissuroplasty was performed. After 3\u2009months, secondary commissuroplasty was performed with an Estlander flap to rebuild the right lower lip. At latest follow\u2010up, 60\u2009months postoperatively, the patient was able to tolerate soft diet with maximal mouth opening of more than 4\u00a0cm; no impairment to mastication, deglutition, or phonation was observed. Speech was normal and the aesthetic outcome was judged good. Double\u2010paddle fibular free flap allows reconstruction of extremely challenging defects, such in case of complete mandibular avulsion. The proximal perforator can provide extended soft\u2010tissue coverage and greater volume than traditional osteocutaneous flaps, avoiding two flaps simultaneous harvest.<\/jats:p>","DOI":"10.1002\/micr.30813","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T15:58:21Z","timestamp":1632412701000},"page":"782-786","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reconstruction after complete mandibular avulsion with double\u2010paddle fibular free flap. 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