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The fibular free flap is the gold standard for mandibular reconstruction, whereas the scapular free flap has emerged as a viable alternative in selected scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective comparative analysis was performed on 69 adults undergoing cervicofacial reconstruction with fibular (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200937) or scapular (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932) osseous free flaps (2015\u20132025). Surgical, functional, and patient-reported outcomes (DASH, EFAS, SHI, MDADI, EORTC QLQ-H&amp;N35, FACE-Q) were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Demographics and clinical profiles were similar, though scapular recipients were older. Fibular flaps predominate in mandibular, scapular in maxillary reconstructions.\u00a0Fibular reconstructions used more custom plates and had longer follow-up but exhibited higher donor-site complication (24.3%) and elective revision (62.2%) rates.\u00a0PROMs were comparable; extensive scapular flaps caused mild upper limb function decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Scapular flaps demonstrated lower donor-site complication rates and comparable functional and patient-reported outcomes in this cohort. These findings suggest that the scapular flap represents a valuable reconstructive alternative, particularly in patients in whom fibular harvest may be less suitable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-026-10299-5","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T20:48:47Z","timestamp":1778532527000},"page":"5899-5911","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes of fibular and scapular free osseous flaps in head and neck reconstruction: a retrospective comparative study"],"prefix":"10.1007","volume":"283","author":[{"given":"Vittorio","family":"Favero","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Sala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7132-3945","authenticated-orcid":false,"given":"Francesca","family":"Mazzarella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Bissolotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Ruaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Taboni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Gaudioso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Nicolai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ferrari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Tiengo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"10299_CR1","doi-asserted-by":"publisher","first-page":"2824","DOI":"10.1016\/j.joms.2010.06.177","volume":"68","author":"SM Roser","year":"2010","unstructured":"Roser SM, Ramachandra S, Blair H, Grist W, Carlson GW, Christensen AM et al (2010) The accuracy of virtual surgical planning in free fibula mandibular reconstruction: comparison of planned and final results. 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