Esthetic and functional reconstruction of the posttumoral interrupted mandible with double-barrel fibular free flap graft: rationale for a microsurgical and prosthodontic approach.

Reconstruction after substantial osseous, cutaneous, and muscular tissue loss following a mandibular resection is a challenge. The use of a fibular free flap is an outstanding, but delicate, treatment option. These grafts, using the double-barrel technique, can achieve an almost complete reconstruction of the mandibular defect.

[Cranial-bone grafting under local anesthesia].

Autogenous bone remains the gold standard for preimplant bone-grafting procedure. When important volumes must be grafted with cancellous bone, the calvarial-harvesting site must still be considered, due to the quality of this membranous bone and the safety of the procedure if the surgeon is experimented. To simplify the procedure, the author proposes calvarial-bone harvesting under local anesthesia with a mini-bone plane.

[First treatment of distal loss of tissue on lower limbs. About 15 cases].

Distal extremity of lower limb sustains the complications of loss of tissue: problem of coverage (cutaneous and tendon necrosis, osteoarticular infection. The whole point of the surgery is to fight against the infection by repeated debridments, against the deformations or their correction by early osteosynthesis (pins and external fixation). The coverage is very important in this treatment: either with Vacuum-Assisted Closure (VAC) and skin graft or fasciocutaneous flap.