Work

Review of fixation techniques in double-barrel fibula flap and introduction of a new technique

Year: 2026

Type: article

Abstract: Objective: The fibula flap is the preferred choice for mandibular reconstruction, especially with recent technological advancements. This study presents and evaluates a novel EASY-WEAR-OFF CAD/CAM patient-specific implant (PSI) double-barrel double-plate designed to improve stabilisation and outcomes. Methods: A custom CAD/CAM plate with 2 parts, a long-bar and a short-bar plate, connected by vertical rods, was developed. Implant placement was performed under local anaesthesia alongside the removal of the short-bar plate at 6 months postoperatively. Literature on fixation techniques and CAD/CAM designs was reviewed to contextualise this approach. Results: The double-barrel technique provides greater vertical bone height than the single-bar, reducing the bone gap and improving implant conditions. This PSI shows potential for better patient satisfaction and functional outcomes, supporting easier implant placement and postoperative management. Conclusions: This CAD/CAM PSI may enhance mandibular reconstruction using the double-barrel fibula flap. Further studies with larger cohorts are needed to confirm its clinical benefits and long-term outcomes.

Source: Acta Otorhinolaryngologica Italica

DOI: 10.14639/0392-100x-a1723