目的:研究下颌骨肿瘤及外伤致大面积软硬组织缺损,并行自体游离腓骨肌皮岛重建下颌骨及修复口腔内缺损的软组织的临床应用。方法:2011年3月~2014年3月15例下颌骨肿瘤及外伤后大面积软硬组织缺损的患者,应用显微吻合微血管的方法,移植游离腓骨,修复大面积缺损的下颌骨及口腔内的软组织。术后1、3、6个月观察修复效果,并发症发生及术后下颌骨的恢复情况。结果:15例患者均移植腓骨瓣成活,以上15例患者术后随访1年,面部及下颌外形、咬合情况良好,术区踝关节未出现不稳定情况,语言、咀嚼、吞咽功能恢复正常,供区愈合良好,行走正常。但2例患者术后1个月出现跑步时,下肢疼痛及平衡困难症状,6个月后逐渐改善并恢复相关功能。15例患者术后6个月行全口义齿修复治疗,修复效果可,恢复良好咬合功能及咀嚼功能,未出现颞颌关节紊乱情况。结论:应用自体游离腓骨肌皮岛修复口腔颌面部软硬组织及恢复患者面部外观及口腔重要生理功能方面都可取得满意临床效果。 OBJECTIVE: To study the clinical application of autologous free fibula myocarp island reconstruction of the mandible and the repair of soft tissue defect in oral cavity after mandibular tumor and trauma. METHODS: From March 2011 to March 2014, 15 patients with mandibular tumors and extensive soft and hard tissue defects after trauma were treated with microvascular anastomosis. The free fibula was transplanted to repair the mandible with large area defect and oral cavity Soft tissue. At 1,3 months and 6 months after operation, the effect of repair, the incidence of complications and the recovery of the mandible after operation were observed. Results: All the 15 patients survived. The above 15 patients were followed up for 1 year. The facial and mandibular shape and occlusion were good. The ankle joint did not appear to be unstable. The language, chewing and swallowing functions returned to normal. District healing well, walking normally. However, two patients showed symptoms of lower limb pain and difficulty in balance when they ran one month after operation. After 6 months, they gradually improved and recovered their function. Fifteen patients underwent complete denture repair 6 months after the operation. The repairing effect was good and the occlusal function and masticatory function were recovered without the disturbance of temporomandibular joint. CONCLUSIONS: Satisfactory clinical results can be obtained with the application of autologous free fibula myocarpus to repair the hard and soft tissue of oral and maxillofacial region and restore facial appearance and vital physiological function of oral cavity.