Novel Reconstruction Method Using the Double-Arm Vascularized Fibula Flap and TriLock Bridging Plate System for Segmental Mandibulectomy Including the Anterior Border of the Mandibular Ramus

This study aimed to develop a novel reconstruction method for segmental mandibulectomy. In the authors' opinion, reconstruction of the anterior border of the mandibular ramus using a double-arm vascularized fibular flap is important to prevent deformity due to buccal depression and the accumulation of food debris, thereby eliminating masticatory dead space that cannot be filled with prostheses such as implants or dentures. Using conventional reconstruction plates, the reconstructed bone positioned at the anterior border of the mandibular ramus required either fixing with only 1 screw or using 2 plates for stable fixation, making it difficult to position the plates stably. The TriLock Bridging Plate System (Medartis AG, Switzerland) has 2 arms on the distal side of the plate, which enables stable fixation of the reconstructed bone placed at the anterior border of the mandibular ramus. This innovation has made it possible to securely place the fibula in the ideal position.