Three-dimensional computed tomography-based contouring of a free fibula bone graft for mandibular reconstruction

The fibula osteo-cutaneous free flap is considered the tissue of choice for mandibular reconstruction. The fibula, a linear bone, has to be contoured accurately by osteotomies to restore the 3-dimensional (3D) form and occlusal relationship with the opposing maxillary dentition, and to regain the form and function of the neo-mandible. The conventional method of reconstruction of the mandible involves contouring a metal plate before resection of the involved bone segment, and to use it as a template to contour the neo-mandible. This technique, however, is not possible in situations where the hemimandible is absent (Fig 1) or is distorted by pathology (Fig 2). We report on a technique of creating a virtual neo-mandible, and using it as a template to contour the fibula.