{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:25:45Z","timestamp":1762431945637},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Osteoradionecrosis (ORN) is one of the most severe complications of free fibula reconstruction after radiotherapy. The gold standard treatment of osteomyelitis involves extensive debridement, antibiotics, and sufficiently vascularized muscle flap coverage for better circulation. Therefore, we hypothesized that free fibula flap with muscle could decrease the risk of ORN.<\/jats:p><jats:p>\n          Methods\u2003This study consisted of 85 patients who underwent reconstruction with free fibula flap in head and neck cancer by a single reconstructive surgeon at Kaohsiung Veterans General Hospital over a period of 19 years (1998\u20132016). Patients with postoperative adjuvant radiotherapy were included in the study and were grouped by either free fibula osteocutaneous flap or free fibula osteomyocutaneous flap (with flexor hallucis longus muscle), and the incidence of ORN was compared.<\/jats:p><jats:p>\n          Results\u2003Of the 85 patients, 15 were reconstructed with osteocutaneous fibula flap and 70 were with osteomyocutaneous fibula flap. The rate of ORN or osteomyelitis was significantly lower in the muscle group (18.6%, n\u2009=\u200913\/70 vs. 46.7%, n\u2009=\u20097\/15, p\u2009=\u20090.020, Chi-square test).<\/jats:p><jats:p>\n          Conclusion\u2003Vascularized muscle transfer increases perfusion of surrounding tissues and the bone flap, thereby decreasing the incidence of osteomyelitis or osteonecrosis.<\/jats:p>","DOI":"10.1055\/s-0040-1722647","type":"journal-article","created":{"date-parts":[[2021,1,31]],"date-time":"2021-01-31T23:32:50Z","timestamp":1612135970000},"page":"524-529","source":"Crossref","is-referenced-by-count":7,"title":["Osteomyocutaneous Free Fibula Flap Prevents Osteoradionecrosis and Osteomyelitis in Head and Neck Cancer Reconstruction"],"prefix":"10.1055","volume":"37","author":[{"given":"Kuan-Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China"},{"name":"Division of Plastic Surgery and Reconstructive Surgery, Chuanghua Christian Hospital, Chuanghua, Taiwan, Republic of China"},{"name":"School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Chung","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China"},{"name":"School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China"},{"name":"School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Feng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oromaxillofacial Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China"},{"name":"Dental Laboratory Technology, Shu Zen College of Medicine and Management, Kaohsiung, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China"},{"name":"School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"International Medical Service Center of China Medical University Hospital, Taichung City, Taiwan, Republic of China"},{"name":"Department of Plastic Surgery, China Medical University, Taichung City, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo-Chung","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China"},{"name":"School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China"},{"name":"School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,1,31]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/0278-2391(83)90294-X","article-title":"Osteoradionecrosis: a new concept of its pathophysiology","volume":"41","author":"R E Marx","year":"1983","journal-title":"J Oral Maxillofac Surg"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1016\/S0278-2391(10)80131-4","article-title":"Osteomyelitis of the jaws: a 50-year perspective","volume":"51","author":"J W Hudson","year":"1993","journal-title":"J Oral Maxillofac 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