ASSESSING FUNCTIONAL OUTCOMES IN POST ONCOLOGICAL RECONSTRUCTION OF THE MANDIBLE WITH A FREE FIBULA FLAP

Background: Mandibular defects following oncologic resections present significant challenges in restoring both form and function. The free fibula flap (FFF) has emerged as the gold standard for oromandibular reconstruction due to its versatility, reliability, and ability to support vascularized bone and soft tissue transfer. Early functional outcomes provide critical insight into recovery trajectories, yet are often underreported, particularly within the initial six weeks post-surgery. This study aims to address that gap through early outcome assessment. Objective: To evaluate early postoperative functional outcomes in patients undergoing oncological mandibular reconstruction using a free fibula flap. Methods: This longitudinal, prospective study was conducted at the Department of Plastic Surgery, Shifa International Hospital, Islamabad, over a minimum period of three months. A total of 30 patients aged 18–80 years undergoing mandibular reconstruction with FFF were enrolled using non-probability consecutive sampling. Functional outcomes were assessed six weeks postoperatively using the Rogers 11-item clinical scoring system (range: 0–29), with scores categorized as unsatisfactory (0–11), satisfactory (12–17), good (18–23), and excellent (24–29). Data were analyzed using SPSS v26.0, with p-values <0.05 considered statistically significant. Results: The mean patient age was 54.3 ± 11.2 years, and the male-to-female ratio was 2:1. The average defect size reconstructed was 7.8 ± 1.3 cm, and the mean Rogers score was 21.6 ± 4.1. A total of 46.6% of patients had good outcomes, 26.6% excellent, 20% satisfactory, and 6.7% unsatisfactory. Modified diet was required in 66.66% of patients, and 86.6% exhibited no drooling. Significant associations were found between functional scores and tumor type and defect size (p = 0.01). Conclusion: Free fibula flap reconstruction offers favorable early functional outcomes in patients undergoing mandibular reconstruction post-oncologic resection. These findings affirm the FFF as a reliable technique for restoring mandibular function and patient quality of life.