{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T08:48:10Z","timestamp":1778575690133,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>(1) Evaluate the association of flap type with late complications in patients undergoing osseous head and neck reconstruction with the fibula free flap (FFF), osteocutaneous radial forearm free flap (OCRFFF), and scapula free flap (SFF). (2) Compare the prevalence of late complications based on minimum duration of follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multiple academic medical centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing FFF, OCRFFF, or SFF with \u22656\u2010month follow\u2010up were stratified by type of flap performed. The association of flap type with late complications was analyzed via univariable and multivariable logistic regression, controlling for relevant clinical risk factors. Additionally, the frequency of late complications by minimum duration of follow\u2010up was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 617 patients were analyzed: 312 (50.6%) FFF, 230 (37.3%) OCRFFFF, and 75 (12.2%) SFF. As compared with the SFF, the FFF (adjusted odds ratio [aOR], 3.05; 95% CI, 1.61\u20105.80) and OCRFFF (aOR, 2.17; 95% CI, 1.12\u20104.22) were independently associated with greater odds of overall late recipient site wound complications. The SFF was independently associated with the lowest odds of hardware exposure when compared with the FFF (aOR, 2.61; 95% CI, 1.27\u20105.41) and OCRFFF (aOR, 2.38; 95% CI, 1.11\u20105.12). The frequency of late complications rose as minimum duration of follow\u2010up increased until plateauing at 36 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This multi\u2010institutional study suggests that the long\u2010term complication profile of the SFF and OCRFFF compares favorably to the FFF. The SFF may be associated with the fewest overall late recipient site complications and hardware exposure, while the FFF may be associated with the most of these 3 options.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998221116061","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T12:02:07Z","timestamp":1659441727000},"page":"681-687","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A Multi\u2010institutional Analysis of Late Complications in Scapula, Fibula, and Osteocutaneous Radial Forearm Free Flaps"],"prefix":"10.1002","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-5338","authenticated-orcid":false,"given":"Craig A.","family":"Bollig","sequence":"first","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School  New Brunswick New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Walia","sequence":"additional","affiliation":[{"name":"Washington University in St Louis  St Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrik J.","family":"Pipkorn","sequence":"additional","affiliation":[{"name":"Washington University in St Louis  St Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan S.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Washington University in St Louis  St Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidharth V.","family":"Puram","sequence":"additional","affiliation":[{"name":"Washington University in St Louis  St Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason T.","family":"Rich","sequence":"additional","affiliation":[{"name":"Washington University in St Louis  St Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randy C.","family":"Paniello","sequence":"additional","affiliation":[{"name":"Washington University in St Louis  St Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose P.","family":"Zevallos","sequence":"additional","affiliation":[{"name":"Washington University in St Louis  St Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madelyn N.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Burton","family":"Wood","sequence":"additional","affiliation":[{"name":"Tennessee Health Science Center  Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah L.","family":"Rohde","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Sykes","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran","family":"Kakarala","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres","family":"Bur","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret 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