Evidence map›Paper›PMID 37030287›Full record

ArticleJournal of reconstructive microsurgery2024

Miniplate Versus Reconstruction Bar Fixation for Oncologic Mandibular Reconstruction with Free Fibula Flaps.

Zack Cohen, Francis D Graziano, Meghana G Shamsunder, Farooq Shahzad, Jay O Boyle, Marc A Cohen, Evan Matros, Jonas A Nelson, Robert J Allen

Abstract read
In one paragraph

Article in Journal of reconstructive microsurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Zack CohenPlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Francis D GrazianoPlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Meghana G ShamsunderPlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Farooq ShahzadPlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Jay O BoylePlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Marc A CohenPlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Evan MatrosPlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Jonas A NelsonPlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Robert J AllenPlastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundFibula free flaps (FFF) are the gold standard tissue for the reconstruction of segmental mandibular defects. A comparison of miniplate (MP) and reconstruction bar (RB)-based fixation of FFFs has been previously described in a systematic review; however, long-term, single-center studies comparing the two plating methods are lacking. The authors aim to examine the complication profile between MPs and RBs at a single tertiary cancer center. We hypothesized that increased components and a lack of rigid fixation inherent to MPs would lead to higher rates of hardware exposure/failure.

methodsA retrospective review was performed from a prospectively maintained database at Memorial Sloan Kettering Cancer Center. All patients who underwent FFF-based reconstruction of mandibular defects between 2015 and 2021 were included. Data on patient demographics, medical risk factors, operative indications, and chemoradiation were collected. The primary outcomes of interest were perioperative flap-related complications, long-term union rates, osteoradionecrosis (ORN), return to the operating room (OR), and hardware exposure/failure. Recipient site complications were further stratified into two groups: early (<90 days) and late (>90 days).

resultsIn total, 96 patients met the inclusion criteria (RB = 63, MP = 33). Patients in both groups were similar with respect to age, presence of comorbidities, smoking history, and operative characteristics. The mean follow-up period was 17.24 months. In total, 60.6 and 54.0% of patients in the MP and RB cohorts received adjuvant radiation, respectively. There were no differences in rates of hardware failure overall; however, in patients with an initial complication after 90 days, MPs had significantly higher rates of hardware exposure (3 vs. 0,

conclusionMPs were found to have a higher risk of exposed hardware in patients with a late initial recipient site complication. It is possible that improved fixation with highly adaptive RBs designed by computer-aided design/manufacturing technology explains these results. Future studies are needed to assess the effects of rigid mandibular fixation on patient-reported outcome measures in this unique population.

Indexed as

Free Tissue FlapsMandibular ReconstructionBone TransplantationFibulaHumansMandibleRetrospective StudiesTreatment Outcome

Identifiers

PMID37030287
PMCPMC11334751

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.