Hardware Failure after Osseous Free Flap Reconstruction

Abstract

Objectives:

Understand the underlying reasons for hardware failure after osseous free flap reconstruction.

Methods:

A retrospective chart review of 224 patients undergoing 241 vascularized osseous mandibular reconstructions between the years of 2004-2012 was conducted with a minimum of 6 months follow-up.

Results:

There were 33 (14.7%) patients who underwent removal of the support implant with the most common reason being infection, exposure, or both. The average length of time to removal was 16.3 months, with a bimodal distribution: the majority of removals occurred within the first year, and the second group occurred in the third year. Of patients who had the hardware removed after 3 months, there were 12 (36.4%) who had malunion at the time of removal. In those patients, the inciting factor was resolved upon removal for 18.2% (n = 6) of cases.

Conclusions:

Removal of the supporting hardware most commonly occurs from infection or exposure in the first year. In the majority of cases, the bone is well healed and the problem resolves with removal.