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. 2021 Sep 24;11:731336. doi: 10.3389/fonc.2021.731336

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Copyright © 2021 Ritschl, Kilbertus, Grill, Schwarz, Weitz, Nieberler, Wolff and Fichter

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Clinical example with intraoperative images of a case with hemimandibulectomy with exarticulation (Brown IIc) due to chronic osteomyelitis. Reconstruction was performed with a three-segment free fibular flap (FFF), with the corpus section reconstructed with a double-barrel component for better neomandibula contouring and crestal bone position for secondary enossal implant insertion. (A) FFF following osteotomies with temporarily applied cutting guides, (B, C) reconstruction of the ramus including neo-condylar head and crestal corpus section applying a repositioning aid and pre-bent 2.0 miniplate osteosynthesis, (D) positioning of the neomandibula with another repositioning aid, and (E) final reconstructive result with the double-barreled caudal FFF section for optimized bony countering.