Do functional scores of flap donor sites recover after reconstruction of segmental jaw defects

Summary Purpose The potential for donor site morbidity in major maxillofacial reconstruction remains a concern. The purpose of this study is to compare the outcome of donor site morbidity of DCIA and scapula free flaps after radical treatment of the jaw and flap reconstruction. Methods The authors implemented a prospective cohort study design. Subjects requiring segmental resection for benign pathology underwent reconstruction with either DCIA or a scapula free flap. The primary predictor variable was use of DCIA versus scapula. The primary outcome variable was change in the orthopedic functional scores for both donor sites. Secondary outcome variables were neurosensory recovery at the recipient site. Results 8 patients have been included in the study, 3 patients were female (38%) and 5 were male (62%). The orthopedic scores were assigned at: T0 - preoperatively, T1 - 1-3 and T2 - 6-12 months postoperative follow-up appointments. In patients with DCIA flaps, a significant (p = 0.0096) reduction of the score value between examination time points T0 and T1 was found. The score then improved on the operated side between T1 and T2 by an average of 29 points and showed no significant difference to the preoperative level (p = 0.68). Patients with a scapular graft showed a significant (p = 0.004) reduction in the score value between T0-T1 on the operated side. The Constant-Murley score then improved again significantly (p =0.0136) between T1-T2. Most of the patients (n = 7, 88%) had a neurologically unremarkable local situation of the recipient site preoperatively, one patient had level A (mild) and one - level B (moderate) neurosensory disorders at T1. At T2, all patients restored their initial neurological scores. Conclusions The donor site morbidity associated with DCIA and scapula flap reconstruction is a short-term condition and returns to baseline by 3-6 months.