{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:40:49Z","timestamp":1789699249335,"version":"4.0.1"},"reference-count":45,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,29]],"date-time":"2023-01-29T00:00:00Z","timestamp":1674950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Reconstruction of defects of the jaws is mainly performed via free fibula flap. An incidence of 2\u201321% of overall flap failure is still described. We investigated the roles of volume, length and number of fibula flap segments on flap survival using novel three-dimensional segmentation tools. We also analyzed the role of other possible risk factors. Seventy-one consecutive patients with a follow up of at least three months and who underwent free fibula flap reconstruction in a single center between 2002 and 2022 have been evaluated. A total of 166 fibula segments were analyzed. Malignancies were the main reason of resection (45.1%). In 69% of the cases a reconstruction of the mandible was performed. The flaps were mainly divided in two segments (39%) (range 1\u20134), with a mean length of 2.52 cm and a mean volume was 3.37 cm3. Total flap failure (TFF) occurred in 12 cases, (16.9%), while partial flap failure (PFF) appeared in 3 patients (4.2%). Volume, length and number of fibula flap segments did not seem to influence flap failure incidence in uni- and multivariate analysis. Reconstruction of the maxilla and use of a recipient vessel different from the facial artery seemed to significantly impact on flap failure. Smoking and previous surgeries showed a higher trend to flap failure, but they did not reach statistical significance. Prospective and multicentric analysis on a wider population should be assessed.<\/jats:p>","DOI":"10.3390\/reports6010004","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T07:56:48Z","timestamp":1675065408000},"page":"4","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["An Analysis of Volume, Length and Segmentation of Free Fibula Flap in Reconstruction of the Jaws: Investigation of Their Role on Flap Failure"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6142-7620","authenticated-orcid":false,"given":"Mattia","family":"Di Bartolomeo","sequence":"first","affiliation":[{"name":"Surgery, Dentistry, Maternity and Infant Department, Unit of Dentistry and Maxillo-Facial Surgery, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2564-9610","authenticated-orcid":false,"given":"Irene Laura","family":"Lusetti","sequence":"additional","affiliation":[{"name":"Plastic Surgery, University of Modena e Reggio, Policlinico di Modena, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Pinelli","sequence":"additional","affiliation":[{"name":"Plastic Surgery, University of Modena e Reggio, Policlinico di Modena, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Negrello","sequence":"additional","affiliation":[{"name":"Cranio-Maxillo-Facial Surgery Unit, University Hospital of Modena, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4880-5057","authenticated-orcid":false,"given":"Arrigo","family":"Pellacani","sequence":"additional","affiliation":[{"name":"Surgery, Dentistry, Maternity and Infant Department, Unit of Dentistry and Maxillo-Facial Surgery, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6720-3564","authenticated-orcid":false,"given":"Stefano","family":"Angelini","sequence":"additional","affiliation":[{"name":"U.O.C. Hematology and Cellular Therapy, Ospedale Mazzoni, 63100 Ascoli Piceno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Chiarini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences for Children & Adults, Cranio-Maxillo-Facial Surgery, University of Modena and Reggio Emilia, Largo del Pozzo 71, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Nocini","sequence":"additional","affiliation":[{"name":"Section of Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"De Santis","sequence":"additional","affiliation":[{"name":"Plastic Surgery, University of Modena e Reggio, Policlinico di Modena, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5281-6840","authenticated-orcid":false,"given":"Alexandre","family":"Anesi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences for Children & Adults, Cranio-Maxillo-Facial Surgery, University of Modena and Reggio Emilia, Largo del Pozzo 71, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,29]]},"reference":[{"key":"ref_1","first-page":"e30161","article-title":"Approach for Mandibular Reconstruction Using Vascularized Free Fibula Flap: A Review of the Literature","volume":"14","author":"Fatani","year":"2022","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/1457496918772365","article-title":"Clinical Comparison of Scapular, Fibular, and Iliac Crest Osseal Free Flaps in Maxillofacial Reconstructions","volume":"108","author":"Wilkman","year":"2019","journal-title":"Scand. 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