[Combined transplantation of a free skin island flap supplied by a septo-cutaneous perforator of the posterior tibial artery and the underlying fibula for the full reconstruction of the mandible and the mouth floor]. / Az arteria tibialis posteriorból eredo direkt septocutan perforator ér által ellátott különálló borszigetlebeny és a fibula kettos szabad átültetése a mandibula és a szájfenék kombinált rekonstrukciója kapcsán.

Microsurgical transplantation of the osteo-cutaneous fibula as a free flap to reconstruct the defect following radical resection of a mouth floor's tumor is a well-known and often applied procedure. Anatomy of the vessels supplying this flap is recognized but it may have some rare and unexpected variations. In this case report we discuss the reconstruction of the middle and lateral parts of the mandible which was resected due to a T4 gingival tumor. Interestingly, the aforementioned segment of the fibula and the overlying skin island were supplied by different pedicles, both emerging from the posterior tibial vessels. Both flaps were transplanted using autologous arterial and venous grafts of the peroneal artery and vein in case of the fibula. We believe this case is worth publishing due to its relative rarity in the literature and the applied surgical method.

[Mandibular reconstruction with free osteocutaneous fibula flap using the occipital artery as recipient vessel]. / Mandibularekonstrukció arteria occipitalisra varrt szabad osteocutan fibulalebennyel.

Authors performed reconstructive surgery for extensive skin and mandibular bone defect following gunshot injury to the left side of the face. The soft tissue and bone defect was reconstructed with the free osteocutaneous fibula flap harvested from the left lower leg, as suitable local reconstructive flap was not available. The bony continuity was reestablished with a 7 cm long fibula segment. Microvascular anastomoses were performed to the left occipital artery and the left internal jugular vein. The occipital artery was chosen as the external carotid system was completely missing on the right side and was missing several branches on the left side due to the trauma. The fibular segment became fully incorporated and 95% of the flap healed by primary intention.