{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:11:53Z","timestamp":1790442713628,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004844","name":"National Cheng Kung University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004844","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2023,2]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Plate\u2010related complications are major long\u2010term complications in mandible reconstruction. There are controversies regarding the use of a reconstruction plate versus miniplates and a bone flap versus a soft tissue flap with a bridging plate. Direct comparisons of a fibula flap and an anterolateral thigh flap, the applicability between a reconstruction plate and miniplate, and the correlation between plate\u2010related complications and quality of life remain unclarified. Therefore, this study aimed to the explore complications of different flaps and plates and how they impact the patients' quality of life.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively reviewed the medical records of a total of 205 patients aged >18\u2009years who underwent segmental mandibulectomy and reconstruction using fibula flap with reconstruction plate (FR;\n n<\/jats:italic>\n \u00a0=\u00a086), fibula flap with miniplate (FM;\n n<\/jats:italic>\n \u00a0=\u00a061), and anterolateral thigh flap with reconstruction plate (AR;\n n<\/jats:italic>\n \u00a0=\u00a058) due to cancer ablation, osteoradionecrosis, or benign tumor excision between August 2010 and December 2019. Data on characteristics, complications, and health\u2010related quality of life were collected and analyzed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The plate\u2010related complication rate was the highest in the AR group (37.9%), then in the FR group (25.6%), and was the lowest in the FM group (13.1%;\n p<\/jats:italic>\n \u00a0=\u00a00.0079). The plate exposure rate was the highest in the AR group (24.1%), then in the FR group (15.7%), and was the lowest in the FM group (4.9%;\n p<\/jats:italic>\n \u00a0=\u00a00.0128). The plate fracture and dislodge rates for the AR group were both higher than those for the FR and FM groups (24.1% versus 9.3% versus 9.8%, respectively;\n p<\/jats:italic>\n \u00a0=\u00a00.023). The AR group had worse complication\u2010free survival (hazard ratio [HR]: 3.61, 95% CI: 1.99\u20136.56, and\n p<\/jats:italic>\n \u2009<\u20090.0001) than the FR and FM groups. Osteoradionecrosis (HR: 6.19, 95% CI: 2.11\u201318.21, and\n p<\/jats:italic>\n \u00a0=\u00a00.0009) and postoperative radiotherapy (HR: 2.87, 95% CI: 1.34\u20136.12, and\n p<\/jats:italic>\n \u00a0=\u00a00.0402) were both independent adverse factors for complication\u2010free survival, whereas patient treated primarily (HR: 0.35, 95% CI: 0.17\u20130.73, and\n p<\/jats:italic>\n \u00a0=\u00a00.0048) was an independent protective factor. Plate\u2010related complication negatively impacted the quality of life based on pain scores (\n \u03b2<\/jats:italic>\n : \u22120.56, SE: 0.26, and\n p<\/jats:italic>\n \u00a0=\u00a00.034).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Using a fibular flap fixed with miniplates and avoiding the use of a reconstruction plate may yield a reduced plate exposure rate and better health\u2010related quality of life, particularly for patients with osteoradionecrosis or those who need postoperative radiotherapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/micr.30893","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T10:27:47Z","timestamp":1652351267000},"page":"131-141","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Plate\u2010related complication and health\u2010related quality of life after mandibular reconstruction by fibula flap with reconstruction plate or miniplate versus anterolateral thigh flap with reconstruction plate"],"prefix":"10.1002","volume":"43","author":[{"given":"Tzu\u2010Yen","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Shuo","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010Ying","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Allied Health Sciences, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3176-4500","authenticated-orcid":false,"given":"Jung\u2010Der","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin\u2010Chen","family":"Pan","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyh\u2010Jou","family":"Shieh","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010Wei","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7937-6785","authenticated-orcid":false,"given":"Yao\u2010Chou","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.125.1.68"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820949223"},{"issue":"7","key":"e_1_2_8_4_1","first-page":"1266","article-title":"Classification of mandibular defects","volume":"92","author":"Boyd J. 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