{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:37:22Z","timestamp":1784183842402,"version":"3.55.0"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"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":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hardware complications (loosening of screws, infection, or exposure of the plate) in mandibular reconstruction with vascularized osseous free flaps impose significant morbidity, and frequently require revision surgery. Purpose of this study was to identify possible contributing factors for hardware complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective cohort study involving case series of patients who underwent microvascular mandible reconstructions between 2000 and 2020. Patient demographics, pathological, clinical, and treatment\u2010related factors were analyzed in univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010one patients were enrolled, encompassing 63 reconstructions with fibular free flaps, 26 reconstructions with scapular, and 2 reconstructions with iliac flaps. Rate of hardware complications and plate exposure was 14.3% and 7.7%, respectively, with a median follow\u2010up time for extrusion of 29\u2009months. In univariate analysis, preoperative radiotherapy (odds ratio [OR]\u00a0=\u00a06.57, <jats:italic>p<\/jats:italic>\u00a0=\u2009.01), and secondary mandible reconstruction (OR\u00a0=\u00a04.3, <jats:italic>p<\/jats:italic>\u00a0=\u2009.04) were significant predictors of hardware complications, and plate exposure was most frequently found in secondary reconstruction (37.5%, OR\u00a0=\u00a011.8, <jats:italic>p<\/jats:italic>\u00a0=\u2009.04). Hypertension was the most commonly found comorbidity (24%), and it trended toward significance regarding plate exposure (<jats:italic>p<\/jats:italic>\u00a0=\u2009.05). Only secondary mandible reconstruction was associated with osteosynthesis complications (OR\u00a0=\u00a012.53, <jats:italic>p<\/jats:italic>\u00a0=\u2009.01) and plate exposure (OR\u00a0=\u00a023.86, <jats:italic>p<\/jats:italic>\u00a0=\u2009.005) on multivariate analysis, while preoperative radiation therapy did not retain its relevance on plate exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Secondary mandible reconstructions with vascularized osseous free flaps have a higher risk of osteosynthesis complications than primary reconstructions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30888","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T11:33:28Z","timestamp":1649849608000},"page":"27-38","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Risk factors associated with fixation\u2010related complications in microsurgical free flap reconstruction of the mandible"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0991-9465","authenticated-orcid":false,"given":"Juan C.","family":"de Vicente","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Central de Asturias (HUCA)  Oviedo Asturias Spain"},{"name":"Department of Surgery University of Oviedo  Oviedo Asturias Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncolog\u00eda del Principado de Asturias (IUOPA) Universidad de Oviedo  Oviedo Asturias Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Rodr\u00edguez\u2010Santamarta","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Central de Asturias (HUCA)  Oviedo Asturias Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncolog\u00eda del Principado de Asturias (IUOPA) Universidad de Oviedo  Oviedo Asturias Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"de Villala\u00edn","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Central de Asturias (HUCA)  Oviedo Asturias Spain"},{"name":"Department of Surgery University of Oviedo  Oviedo Asturias Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncolog\u00eda del Principado de Asturias (IUOPA) Universidad de Oviedo  Oviedo Asturias Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Ruiz\u2010Ranz","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Central de Asturias (HUCA)  Oviedo Asturias Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerea","family":"Rodr\u00edguez\u2010Torres","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Central de Asturias (HUCA)  Oviedo Asturias Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan L.","family":"Cobo","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Hospital Universitario Central de Asturias (HUCA)  Oviedo Asturias 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