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2013 | 27 | 2 | 16-22

Article title

Gait Pattern In Patients After Mandible Reconstruction Using Free Fibula Or Iliac Crest Flaps In The Treatment Of Head And Neck Tumors


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Introduction: Surgical treatment of tumors of the head and neck region is associated with extensive tissue defects. The introduction of modern reconstructive surgery techniques allows replace the resected bone and soft tissue. The aim of reconstruction is to fill the defect and ensure proper appearance and functioning of affected area, but functional defects caused by harvesting the graft are also important for the patient. The aim of this paper is to describe changes in gait pattern and gait parameters after harvesting free fibular flap and the flap from the iliac crest for reconstruction of the mandible in patients treated for head and neck cancer. Material and methods: Two patients who underwent reconstruction with fibular and iliac crest flaps had gait tests performed three times: before, one month and three months after surgery. The patients had an intensive rehabilitation and physiotherapy started on 1st postoperative day and it was continued for 2 months. Results: The analysis of tests results showed deterioration in gait parameters one month after operation. 3 months after operation these parameters returned to the level before surgery. Conclusions: Harvesting fragment of fibula and of iliac crest affects the function of gait. Systematic physical therapy and rehabilitation on inpatient and outpatient basis allowed the patients to return to the same level of gait functioning as before the operation. Further research is needed to develop a more complete picture of patobiomechanic after bone resection. The results will help to create standard procedure after both treatments.









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1 - 6 - 2013
12 - 4 - 2014


  • Zakład Rehabilitacji Centrum Onkologii –Instytut im. M. Skłodowskiej- Curie w Warszawie
  • Pracownia Diagnostyki Narządu Ruchu, Klinika Rehabilitacji Pediatrycznej, Instytut „Pomnik- Centrum Zdrowia Dziecka”
  • Klinika Nowotworów Głowy i Szyi Centrum Onkologii-Instytut im. M. Skłodowskiej- Curie w Warszawie
  • Zakład Rehabilitacji Centrum Onkologii –Instytut im. M. Skłodowskiej- Curie w Warszawie
  • Klinika Nowotworów Głowy i Szyi Centrum Onkologii-Instytut im. M. Skłodowskiej- Curie w Warszawie


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  • 2. Bailey BJ, Johnson, JT, Newlands SD. Head and Neck Surgery. Fourth Edition. Otolaryngology 2006:2382-2383.
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  • 4. Lin JY, Djohan R, Dobryansky M, Chou SW, Hou WH, Chen MH, et al. Assessment of donor-site morbidity using balance and gait tests after bilateral fibula osteoseptocutaneous free flap transfer. Ann Plast Surg 2009; 62(3):246-51.[WoS]
  • 5. Lee JH, Chung CY, Myoung H, Kim MJ, Yun PY. Gait analysis of donor leg after free fibular flap transfer. Int J Oral Maxillofac Surg 2008; 37(7):625-9.[WoS]
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  • 8. Ramasastry SS, Granick MS, Futrell JW. Clinical anatomy of the internal oblique muscle. J Reconstr Microsurg 1986; 2(2):117-22.[PubMed][Crossref]
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  • 10. Bianchi B, Ferri A, Ferrari S, Copelli C, Boni P, Sesenna E. Iliac crest free flap for maxillary reconstruction. J Oral Maxillofac Surg 2010; 68(11):2706-13.[PubMed]
  • 11. Forrest C, Boyd B, Manktelow R, Zuker R, Bowen V. The free vascularised iliac crest tissue transfer: donor site complications associated with eighty-two cases. Br J Plast Surg 1992; 45(2):89-93.

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