Risk Factors and Surgical Refinements of Postresective Mandibular Reconstruction: A Retrospective Study
Identifieur interne : 000111 ( Pmc/Checkpoint ); précédent : 000110; suivant : 000112Risk Factors and Surgical Refinements of Postresective Mandibular Reconstruction: A Retrospective Study
Auteurs : Akiko Sakakibara [Japon] ; Kazunobu Hashikawa [Japon] ; Satoshi Yokoo [Japon] ; Shunsuke Sakakibara [Japon] ; Takahide Komori [Japon] ; Shinya Tahara [Japon]Source :
- Plastic Surgery International [ 2090-1461 ] ; 2014.
Abstract
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DOI: 10.1155/2014/893746
PubMed: 25228992
PubMed Central: 4150385
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Risk Factors and Surgical Refinements of Postresective Mandibular Reconstruction: A Retrospective Study</title><author><name sortKey="Sakakibara, Akiko" sort="Sakakibara, Akiko" uniqKey="Sakakibara A" first="Akiko" last="Sakakibara">Akiko Sakakibara</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017</wicri:regionArea><wicri:noRegion>Kobe 650-0017</wicri:noRegion></affiliation></author><author><name sortKey="Hashikawa, Kazunobu" sort="Hashikawa, Kazunobu" uniqKey="Hashikawa K" first="Kazunobu" last="Hashikawa">Kazunobu Hashikawa</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017</wicri:regionArea><wicri:noRegion>Kobe 650-0017</wicri:noRegion></affiliation></author><author><name sortKey="Yokoo, Satoshi" sort="Yokoo, Satoshi" uniqKey="Yokoo S" first="Satoshi" last="Yokoo">Satoshi Yokoo</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma 371-8511</wicri:regionArea><wicri:noRegion>Gunma 371-8511</wicri:noRegion></affiliation></author><author><name sortKey="Sakakibara, Shunsuke" sort="Sakakibara, Shunsuke" uniqKey="Sakakibara S" first="Shunsuke" last="Sakakibara">Shunsuke Sakakibara</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017</wicri:regionArea><wicri:noRegion>Kobe 650-0017</wicri:noRegion></affiliation></author><author><name sortKey="Komori, Takahide" sort="Komori, Takahide" uniqKey="Komori T" first="Takahide" last="Komori">Takahide Komori</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017</wicri:regionArea><wicri:noRegion>Kobe 650-0017</wicri:noRegion></affiliation></author><author><name sortKey="Tahara, Shinya" sort="Tahara, Shinya" uniqKey="Tahara S" first="Shinya" last="Tahara">Shinya Tahara</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Plastic Surgery, Japanese Red Cross Kobe Hospital, Kobe 651-0073, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic Surgery, Japanese Red Cross Kobe Hospital, Kobe 651-0073</wicri:regionArea><wicri:noRegion>Kobe 651-0073</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25228992</idno><idno type="pmc">4150385</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4150385</idno><idno type="RBID">PMC:4150385</idno><idno type="doi">10.1155/2014/893746</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000768</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000768</idno><idno type="wicri:Area/Pmc/Curation">000768</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000768</idno><idno type="wicri:Area/Pmc/Checkpoint">000111</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000111</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Risk Factors and Surgical Refinements of Postresective Mandibular Reconstruction: A Retrospective Study</title><author><name sortKey="Sakakibara, Akiko" sort="Sakakibara, Akiko" uniqKey="Sakakibara A" first="Akiko" last="Sakakibara">Akiko Sakakibara</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017</wicri:regionArea><wicri:noRegion>Kobe 650-0017</wicri:noRegion></affiliation></author><author><name sortKey="Hashikawa, Kazunobu" sort="Hashikawa, Kazunobu" uniqKey="Hashikawa K" first="Kazunobu" last="Hashikawa">Kazunobu Hashikawa</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017</wicri:regionArea><wicri:noRegion>Kobe 650-0017</wicri:noRegion></affiliation></author><author><name sortKey="Yokoo, Satoshi" sort="Yokoo, Satoshi" uniqKey="Yokoo S" first="Satoshi" last="Yokoo">Satoshi Yokoo</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma 371-8511</wicri:regionArea><wicri:noRegion>Gunma 371-8511</wicri:noRegion></affiliation></author><author><name sortKey="Sakakibara, Shunsuke" sort="Sakakibara, Shunsuke" uniqKey="Sakakibara S" first="Shunsuke" last="Sakakibara">Shunsuke Sakakibara</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017</wicri:regionArea><wicri:noRegion>Kobe 650-0017</wicri:noRegion></affiliation></author><author><name sortKey="Komori, Takahide" sort="Komori, Takahide" uniqKey="Komori T" first="Takahide" last="Komori">Takahide Komori</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017</wicri:regionArea><wicri:noRegion>Kobe 650-0017</wicri:noRegion></affiliation></author><author><name sortKey="Tahara, Shinya" sort="Tahara, Shinya" uniqKey="Tahara S" first="Shinya" last="Tahara">Shinya Tahara</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Plastic Surgery, Japanese Red Cross Kobe Hospital, Kobe 651-0073, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic Surgery, Japanese Red Cross Kobe Hospital, Kobe 651-0073</wicri:regionArea><wicri:noRegion>Kobe 651-0073</wicri:noRegion></affiliation></author></analytic><series><title level="j">Plastic Surgery International</title><idno type="ISSN">2090-1461</idno><idno type="eISSN">2090-147X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><italic>Background.</italic> Postresective mandibular reconstruction is common in cases of oral and mandibular tumors. However, complications such as infection, plate exposure, or plate fracture can occur. We identified several significant risk factors of complications after reconstructive surgery and compared the effectiveness of different surgical techniques for reducing the incidence of complications. <italic>Methods.</italic> This study is a retrospective analysis of 28 oromandibular cancer cases that required reconstructive surgery between January 1999 and December 2011 at Kobe University Graduate School of Medicine in Japan. All cases were classified using Hashikawa's CAT and Eichner's classification methods. Then, we determined whether these classifications and different treatment or surgical methods were significantly related to complications. <italic>Results.</italic> Complications after mandibular reconstruction occurred in 10/28 patients (36%). Specifically, five patients had plate fractures, four had plate exposures, and one had an infection. Radiation therapy and closure without any flaps were significantly related to infection or plate exposure. The wrap-around technique of securing reconstruction plates was used in 14 cases, whereas the run-through technique was used in two cases. <italic>Conclusions.</italic> The success of mandibular reconstruction depends on both mechanical and biological factors, such as the location of defects, presence of occlusions, and the amount of vascularization of the flap.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hidalgo, Da" uniqKey="Hidalgo D">DA Hidalgo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anthony, Jp" uniqKey="Anthony J">JP Anthony</name></author><author><name sortKey="Rawnsley, Jd" uniqKey="Rawnsley J">JD Rawnsley</name></author><author><name sortKey="Benhaim, P" uniqKey="Benhaim P">P Benhaim</name></author><author><name sortKey="Ritter, Ef" uniqKey="Ritter E">EF Ritter</name></author><author><name sortKey="Sadowsky, Sh" uniqKey="Sadowsky S">SH Sadowsky</name></author><author><name 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uniqKey="Weinberg H">H Weinberg</name></author><author><name sortKey="Vickery, C" uniqKey="Vickery C">C Vickery</name></author><author><name sortKey="Buchbinder, D" uniqKey="Buchbinder D">D Buchbinder</name></author><author><name sortKey="Lawson, W" uniqKey="Lawson W">W Lawson</name></author><author><name sortKey="Biller, Hf" uniqKey="Biller H">HF Biller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hashikawa, K" uniqKey="Hashikawa K">K Hashikawa</name></author><author><name sortKey="Yokoo, S" uniqKey="Yokoo S">S Yokoo</name></author><author><name sortKey="Tahara, S" uniqKey="Tahara S">S Tahara</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eichner, K" uniqKey="Eichner K">K Eichner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shibahara, T" uniqKey="Shibahara T">T Shibahara</name></author><author><name sortKey="Noma, H" uniqKey="Noma H">H Noma</name></author><author><name sortKey="Furuya, Y" uniqKey="Furuya Y">Y Furuya</name></author><author><name sortKey="Takaki, R" uniqKey="Takaki R">R Takaki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boyd, Jb" uniqKey="Boyd J">JB Boyd</name></author><author><name sortKey="Mulholland, Rs" uniqKey="Mulholland R">RS Mulholland</name></author><author><name sortKey="Davidson, J" uniqKey="Davidson J">J Davidson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Knoll, W" uniqKey="Knoll W">W Knoll</name></author><author><name sortKey="Gaida, A" uniqKey="Gaida A">A Gaida</name></author><author><name sortKey="Maurer, P" uniqKey="Maurer P">P Maurer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arias Gallo, J" uniqKey="Arias Gallo J">J Arias-Gallo</name></author><author><name sortKey="Maremonti, P" uniqKey="Maremonti P">P Maremonti</name></author><author><name sortKey="Gonzalez Otero, T" uniqKey="Gonzalez Otero T">T 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Plast Surg Int</journal-id><journal-id journal-id-type="iso-abbrev">Plast Surg Int</journal-id><journal-id journal-id-type="publisher-id">PSI</journal-id><journal-title-group><journal-title>Plastic Surgery International</journal-title></journal-title-group><issn pub-type="ppub">2090-1461</issn><issn pub-type="epub">2090-147X</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25228992</article-id><article-id pub-id-type="pmc">4150385</article-id><article-id pub-id-type="doi">10.1155/2014/893746</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>Risk Factors and Surgical Refinements of Postresective Mandibular Reconstruction: A Retrospective Study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sakakibara</surname><given-names>Akiko</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Hashikawa</surname><given-names>Kazunobu</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Yokoo</surname><given-names>Satoshi</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sakakibara</surname><given-names>Shunsuke</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Komori</surname><given-names>Takahide</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tahara</surname><given-names>Shinya</given-names></name><xref ref-type="aff" rid="I4"><sup>4</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</aff><aff id="I2"><sup>2</sup>Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan</aff><aff id="I3"><sup>3</sup>Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan</aff><aff id="I4"><sup>4</sup>Department of Plastic Surgery, Japanese Red Cross Kobe Hospital, Kobe 651-0073, Japan</aff><author-notes><corresp id="cor1">*Akiko Sakakibara: <email>oguni@cool.odn.ne.jp</email></corresp><fn fn-type="other"><p>Academic Editor: Francesco Carinci</p></fn></author-notes><pub-date pub-type="ppub"><year>2014</year></pub-date><pub-date pub-type="epub"><day>6</day><month>8</month><year>2014</year></pub-date><volume>2014</volume><elocation-id>893746</elocation-id><history><date date-type="received"><day>16</day><month>5</month><year>2014</year></date><date date-type="rev-recd"><day>18</day><month>7</month><year>2014</year></date><date date-type="accepted"><day>18</day><month>7</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2014 Akiko Sakakibara et al.</copyright-statement><copyright-year>2014</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p><italic>Background.</italic> Postresective mandibular reconstruction is common in cases of oral and mandibular tumors. However, complications such as infection, plate exposure, or plate fracture can occur. We identified several significant risk factors of complications after reconstructive surgery and compared the effectiveness of different surgical techniques for reducing the incidence of complications. <italic>Methods.</italic> This study is a retrospective analysis of 28 oromandibular cancer cases that required reconstructive surgery between January 1999 and December 2011 at Kobe University Graduate School of Medicine in Japan. All cases were classified using Hashikawa's CAT and Eichner's classification methods. Then, we determined whether these classifications and different treatment or surgical methods were significantly related to complications. <italic>Results.</italic> Complications after mandibular reconstruction occurred in 10/28 patients (36%). Specifically, five patients had plate fractures, four had plate exposures, and one had an infection. Radiation therapy and closure without any flaps were significantly related to infection or plate exposure. The wrap-around technique of securing reconstruction plates was used in 14 cases, whereas the run-through technique was used in two cases. <italic>Conclusions.</italic> The success of mandibular reconstruction depends on both mechanical and biological factors, such as the location of defects, presence of occlusions, and the amount of vascularization of the flap.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>The wrap-around technique involves laying the musculocutaneous flap under the reconstruction plate and then wrapping the plate with muscle, fascia, or a denuded island flap.</p></caption><graphic xlink:href="PSI2014-893746.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>The run-through technique involves inserting the reconstruction plate through a two-island flap. Initially, the plate is positioned for fitting to the mandible but subsequently removed. The plate is penetrated into a layer of deep fascia through the rectus abdominis muscle. Finally, part of the reconstruction plate that is penetrated through the flap is fixed to the mandibular bone. Any surplus flap is denuded and buried under the skin of the neck.</p></caption><graphic xlink:href="PSI2014-893746.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Mandibular reconstruction using a two-island flap. The reconstruction plate is placed on top of the muscle and covered with the skin of the neck.</p></caption><graphic xlink:href="PSI2014-893746.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>The CAT classification system classifies segmental mandibular defects. “C” refers to defects in the condylar head of the mandible, “A” refers to defects in the mandibular angle, and “T” refers to defects in the mental tubercle. For example, resection of the mandibular angle is classified as “A,” resection of the condylar head and mandibular angle is classified as “CA,” resection of the entire hemimandible is classified as “CAT,” and resection of the mandibular angle and bilateral mental tubercle is classified as “ATT.” In addition, the term “body” is used when only the mandibular body is resected, but the mandibular angle and the mental tubercle are preserved. Similarly, the term “neck” is used when only the mandibular ramus is resected, but the condylar head and the mandibular angle are preserved.</p></caption><graphic xlink:href="PSI2014-893746.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Schematic representation of Eichner's index. Shaded teeth indicate occlusal contacts between natural teeth or fixed prostheses in the premolar and molar regions that constitute occlusal support zones (OSZs). Category A contains 4 OSZs. A1: complete dentition. A2: missing teeth in one arch. A3: missing teeth in both arches. Category B contains 1–3 OSZs or contacts in the anterior area only. B1: 3 OSZs. B2: 2 OSZs. B3: 1 OSZ. B4: contacts in the anterior area only. Category C does not have any OSZs. C1: teeth in both arches. C2: teeth in one arch. C3: edentulous.</p></caption><graphic xlink:href="PSI2014-893746.005"></graphic></fig><fig id="fig6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Kaplan-Meier plot showing the success rate of mandibular reconstruction in the patients in this study.</p></caption><graphic xlink:href="PSI2014-893746.006"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Number of cases of plate fracture in each CAT classification. The CAT classification system classifies segmental mandibular defects. “C” refers to defects in the condylar head of the mandible, “A” refers to defects in the mandibular angle, and “T” refers to defects in the mental tubercle.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2" colspan="1">CAT classification</th><th align="center" rowspan="1" colspan="1">Patients </th><th align="center" rowspan="2" colspan="1">Plate fracture cases</th></tr><tr><th align="center" rowspan="1" colspan="1"><italic>n</italic> (%)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">A</td><td align="center" rowspan="1" colspan="1">3 (10.7)</td><td align="center" rowspan="1" colspan="1">2</td></tr><tr><td align="left" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">10 (35.7)</td><td align="center" rowspan="1" colspan="1">3</td></tr><tr><td align="left" rowspan="1" colspan="1">T</td><td align="center" rowspan="1" colspan="1">5 (17.9)</td><td align="center" rowspan="1" colspan="1">1</td></tr><tr><td align="left" rowspan="1" colspan="1">TT</td><td align="center" rowspan="1" colspan="1">7 (25.0)</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="left" rowspan="1" colspan="1">ATT</td><td align="center" rowspan="1" colspan="1">1 (3.8)</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="left" rowspan="1" colspan="1">Body</td><td align="center" rowspan="1" colspan="1">2 (7.1)</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="center" colspan="3" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Total</td><td align="center" rowspan="1" colspan="1">28 (100)</td><td align="center" rowspan="1" colspan="1">6</td></tr></tbody></table></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Number of cases of plate fracture in each Eichner index. Eichner's classification system groups patients according to the presence or absence of occlusal contacts in different dental zones.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2" colspan="1">Eichner's classification</th><th align="center" rowspan="1" colspan="1">Patients </th><th align="center" rowspan="2" colspan="1">Plate fracture cases</th></tr><tr><th align="center" rowspan="1" colspan="1"><italic>n</italic> (%)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">A1-3</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="left" rowspan="1" colspan="1">B1</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="left" rowspan="1" colspan="1">B2</td><td align="center" rowspan="1" colspan="1">5 (17.9)</td><td align="center" rowspan="1" colspan="1">2</td></tr><tr><td align="left" rowspan="1" colspan="1">B3</td><td align="center" rowspan="1" colspan="1">6 (21.4)</td><td align="center" rowspan="1" colspan="1">3</td></tr><tr><td align="left" rowspan="1" colspan="1">B4</td><td align="center" rowspan="1" colspan="1">1 (3.8)</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="left" rowspan="1" colspan="1">C1</td><td align="center" rowspan="1" colspan="1">1 (3.8)</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="left" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">10 (35.7)</td><td align="center" rowspan="1" colspan="1">1</td></tr><tr><td align="left" rowspan="1" colspan="1">C3</td><td align="center" rowspan="1" colspan="1">5 (17.9)</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="center" colspan="3" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Total</td><td align="center" rowspan="1" colspan="1">28 (100)</td><td align="center" rowspan="1" colspan="1">6</td></tr></tbody></table></table-wrap><table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label><caption><p>Number of cases with complications in patients who received radiation therapy.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Radiation therapy</th><th align="center" rowspan="1" colspan="1">Patients <break></break><italic>n</italic> (%)</th><th align="center" rowspan="1" colspan="1">Number of cases with plate infection or exposure</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">5 (17.9)</td><td align="center" rowspan="1" colspan="1">3</td></tr><tr><td align="left" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">23 (82.1)</td><td align="center" rowspan="1" colspan="1">2</td></tr><tr><td align="center" colspan="3" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Total</td><td align="center" rowspan="1" colspan="1">28 (100)</td><td align="center" rowspan="1" colspan="1">5</td></tr></tbody></table></table-wrap><table-wrap id="tab4" orientation="portrait" position="float"><label>Table 4</label><caption><p>Number of cases with complications in each type of soft-tissue free flap. </p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Type of flap</th><th align="center" rowspan="1" colspan="1">Patients <break></break><italic>n</italic> (%)</th><th align="center" rowspan="1" colspan="1">Number of cases with plate infection or exposure</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">No flap</td><td align="center" rowspan="1" colspan="1">1 (3.8)</td><td align="center" rowspan="1" colspan="1">1</td></tr><tr><td align="left" rowspan="1" colspan="1">Radial forearm</td><td align="center" rowspan="1" colspan="1">4 (14.3)</td><td align="center" rowspan="1" colspan="1">2</td></tr><tr><td align="left" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">16 (57.1)</td><td align="center" rowspan="1" colspan="1">1</td></tr><tr><td align="left" rowspan="1" colspan="1">PMMC</td><td align="center" rowspan="1" colspan="1">7 (25.0)</td><td align="center" rowspan="1" colspan="1">1</td></tr><tr><td align="center" colspan="3" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Total</td><td align="center" rowspan="1" colspan="1">28 (100)</td><td align="center" rowspan="1" colspan="1">5</td></tr></tbody></table><table-wrap-foot><fn><p>RAM: rectus abdominis musculocutaneous flap and PMMC: pectoralis major musculocutaneous flap.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab5" orientation="portrait" position="float"><label>Table 5</label><caption><p>Classification and outcomes of all patients who underwent mandibular reconstruction.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Case number</th><th align="center" rowspan="1" colspan="1">Age</th><th align="center" rowspan="1" colspan="1">Sex</th><th align="center" rowspan="1" colspan="1">Follow-up period (months)</th><th align="center" rowspan="1" colspan="1">Type of flap</th><th align="center" rowspan="1" colspan="1">RT</th><th align="center" rowspan="1" colspan="1">Eichner classification</th><th align="center" rowspan="1" colspan="1">CAT classification</th><th align="center" rowspan="1" colspan="1">Complication</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">65</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">13.9</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B3</td><td align="center" rowspan="1" colspan="1">A</td><td align="center" rowspan="1" colspan="1">Plate fracture</td></tr><tr><td align="left" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">64</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">36.3</td><td align="center" rowspan="1" colspan="1">Radial forearm</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B2</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">Plate fracture</td></tr><tr><td align="left" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">80</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">82.4</td><td align="center" rowspan="1" colspan="1"> PMMC</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B2</td><td align="center" rowspan="1" colspan="1">A</td><td align="center" rowspan="1" colspan="1">Plate fracture</td></tr><tr><td align="left" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">63</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">0.65</td><td align="center" rowspan="1" colspan="1">PMMC</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B3</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">Plate infection</td></tr><tr><td align="left" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">61</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">8.5</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B2</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">54</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">47.1</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B2</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">68</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">56.8</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">Plate fracture</td></tr><tr><td align="left" rowspan="1" colspan="1">8</td><td align="center" rowspan="1" colspan="1">52</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">12.0</td><td align="center" rowspan="1" colspan="1">PMMC</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B3</td><td align="center" rowspan="1" colspan="1">T</td><td align="center" rowspan="1" colspan="1">Plate fracture</td></tr><tr><td align="left" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">73</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">0.5</td><td align="center" rowspan="1" colspan="1">None</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">C3</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">Plate exposure</td></tr><tr><td align="left" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">70</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">21.2</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">TT</td><td align="center" rowspan="1" colspan="1">Plate exposure</td></tr><tr><td align="left" rowspan="1" colspan="1">11</td><td align="center" rowspan="1" colspan="1">78</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">4.0</td><td align="center" rowspan="1" colspan="1">Radial forearm</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">T</td><td align="center" rowspan="1" colspan="1">Plate exposure</td></tr><tr><td align="left" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">78</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">27.3</td><td align="center" rowspan="1" colspan="1">Radial forearm</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C3</td><td align="center" rowspan="1" colspan="1">TT</td><td align="center" rowspan="1" colspan="1">Plate exposure</td></tr><tr><td align="left" rowspan="1" colspan="1">13</td><td align="center" rowspan="1" colspan="1">26</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">9.5</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">14</td><td align="center" rowspan="1" colspan="1">77</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">7.1</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C3</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">15</td><td align="center" rowspan="1" colspan="1">66</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">7.9</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C3</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">16</td><td align="center" rowspan="1" colspan="1">48</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">2.2</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">ATT</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">17</td><td align="center" rowspan="1" colspan="1">69</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">43.5</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B3</td><td align="center" rowspan="1" colspan="1">TT</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">18</td><td align="center" rowspan="1" colspan="1">53</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">47.0</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B4</td><td align="center" rowspan="1" colspan="1">TA</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">19</td><td align="center" rowspan="1" colspan="1">78</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">48.3</td><td align="center" rowspan="1" colspan="1">PMMC</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B3</td><td align="center" rowspan="1" colspan="1">T</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">20</td><td align="center" rowspan="1" colspan="1">69</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">50.0</td><td align="center" rowspan="1" colspan="1">PMMC</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B3</td><td align="center" rowspan="1" colspan="1">T</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">21</td><td align="center" rowspan="1" colspan="1">62</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">5.0</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">B2</td><td align="center" rowspan="1" colspan="1">T</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">22</td><td align="center" rowspan="1" colspan="1">89</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">13.2</td><td align="center" rowspan="1" colspan="1">PMMC</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C1</td><td align="center" rowspan="1" colspan="1">A</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">23</td><td align="center" rowspan="1" colspan="1">71</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">58.9</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">TT</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">24</td><td align="center" rowspan="1" colspan="1">66</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">143.8</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">TT</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">25</td><td align="center" rowspan="1" colspan="1">66</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">51.1</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">TT</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">26</td><td align="center" rowspan="1" colspan="1">72</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">23.8</td><td align="center" rowspan="1" colspan="1">Radial forearm</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">Body</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">27</td><td align="center" rowspan="1" colspan="1">76</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">41.2</td><td align="center" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C2</td><td align="center" rowspan="1" colspan="1">TT</td><td align="center" rowspan="1" colspan="1">None</td></tr><tr><td align="left" rowspan="1" colspan="1">28</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">1.0</td><td align="center" rowspan="1" colspan="1">PMMC</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">C3</td><td align="center" rowspan="1" colspan="1">Body</td><td align="center" rowspan="1" colspan="1">None</td></tr></tbody></table><table-wrap-foot><fn><p>RAM: rectus abdominis musculocutaneous flap, PMMC: pectoralis major musculocutaneous flap, and RT: radiation therapy.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab6" orientation="portrait" position="float"><label>Table 6</label><caption><p>Statistical significance of relationships between plate fracture and CAT and Eichner classifications of patients in this study.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Classification</th><th align="center" rowspan="1" colspan="1">Chi-square value</th><th align="center" rowspan="1" colspan="1"><italic>P</italic> value</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Eichner's classification </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> B2</td><td align="center" rowspan="1" colspan="1">1.247</td><td align="center" rowspan="1" colspan="1">0.246</td></tr><tr><td align="left" rowspan="1" colspan="1"> B3</td><td align="center" rowspan="1" colspan="1">3.702</td><td align="center" rowspan="1" colspan="1">0.054</td></tr><tr><td align="left" rowspan="1" colspan="1"> B4</td><td align="center" rowspan="1" colspan="1">0.283</td><td align="center" rowspan="1" colspan="1">0.595</td></tr><tr><td align="left" rowspan="1" colspan="1"> C1</td><td align="center" rowspan="1" colspan="1">0.283</td><td align="center" rowspan="1" colspan="1">0.595</td></tr><tr><td align="left" rowspan="1" colspan="1"> C2</td><td align="center" rowspan="1" colspan="1">1.207</td><td align="center" rowspan="1" colspan="1">0.272</td></tr><tr><td align="left" rowspan="1" colspan="1"> C3</td><td align="center" rowspan="1" colspan="1">1.247</td><td align="center" rowspan="1" colspan="1">0.246</td></tr><tr><td align="left" rowspan="1" colspan="1"> B2 + B3 + B4</td><td align="center" rowspan="1" colspan="1">5.100</td><td align="center" rowspan="1" colspan="1">0.024∗</td></tr><tr><td align="left" rowspan="1" colspan="1">CAT classification</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> A</td><td align="center" rowspan="1" colspan="1">4.084</td><td align="center" rowspan="1" colspan="1">0.043∗</td></tr><tr><td align="left" rowspan="1" colspan="1"> TA</td><td align="center" rowspan="1" colspan="1">0.697</td><td align="center" rowspan="1" colspan="1">0.410</td></tr><tr><td align="left" rowspan="1" colspan="1"> T</td><td align="center" rowspan="1" colspan="1">0.007</td><td align="center" rowspan="1" colspan="1">0.932</td></tr><tr><td align="left" rowspan="1" colspan="1"> TT</td><td align="center" rowspan="1" colspan="1">2.545</td><td align="center" rowspan="1" colspan="1">0.111</td></tr><tr><td align="left" rowspan="1" colspan="1"> ATT</td><td align="center" rowspan="1" colspan="1">0.283</td><td align="center" rowspan="1" colspan="1">0.595</td></tr><tr><td align="left" rowspan="1" colspan="1"> Body</td><td align="center" rowspan="1" colspan="1">0.643</td><td align="center" rowspan="1" colspan="1">0.423</td></tr></tbody></table><table-wrap-foot><fn><p>∗Statistically significant (<italic>P</italic> < 0.05, <italic>χ</italic><sup>2</sup> test).</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab7" orientation="portrait" position="float"><label>Table 7</label><caption><p>Statistical significance of relationships between infection or plate exposure, the type of flap used, and radiation therapy in the mandibular reconstruction of patients in this study.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Risc factor</th><th align="center" rowspan="1" colspan="1">Chi-square value</th><th align="center" rowspan="1" colspan="1"><italic>P</italic> value</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">No flap</td><td align="center" rowspan="1" colspan="1">4.770</td><td align="center" rowspan="1" colspan="1">0.029∗</td></tr><tr><td align="left" rowspan="1" colspan="1">Radial forearm</td><td align="center" rowspan="1" colspan="1">3.287</td><td align="center" rowspan="1" colspan="1">0.070</td></tr><tr><td align="left" rowspan="1" colspan="1">RAM</td><td align="center" rowspan="1" colspan="1">3.429</td><td align="center" rowspan="1" colspan="1">0.064</td></tr><tr><td align="left" rowspan="1" colspan="1">PMMC</td><td align="center" rowspan="1" colspan="1">0.081</td><td align="center" rowspan="1" colspan="1">0.776</td></tr><tr><td align="left" rowspan="1" colspan="1">Radiation therapy</td><td align="center" rowspan="1" colspan="1">7.370</td><td align="center" rowspan="1" colspan="1">0.007∗</td></tr></tbody></table><table-wrap-foot><fn><p>∗Statistically significant (<italic>P</italic> < 0.05, <italic>χ</italic><sup>2</sup> test).</p></fn><fn><p>RAM: rectus abdominis musculocutaneous flap and PMMC: pectoralis major musculocutaneous flap.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Sakakibara, Akiko" sort="Sakakibara, Akiko" uniqKey="Sakakibara A" first="Akiko" last="Sakakibara">Akiko Sakakibara</name></noRegion><name sortKey="Hashikawa, Kazunobu" sort="Hashikawa, Kazunobu" uniqKey="Hashikawa K" first="Kazunobu" last="Hashikawa">Kazunobu Hashikawa</name><name sortKey="Komori, Takahide" sort="Komori, Takahide" uniqKey="Komori T" first="Takahide" last="Komori">Takahide Komori</name><name sortKey="Sakakibara, Shunsuke" sort="Sakakibara, Shunsuke" uniqKey="Sakakibara S" first="Shunsuke" last="Sakakibara">Shunsuke Sakakibara</name><name sortKey="Tahara, Shinya" sort="Tahara, Shinya" uniqKey="Tahara S" first="Shinya" last="Tahara">Shinya Tahara</name><name sortKey="Yokoo, Satoshi" sort="Yokoo, Satoshi" uniqKey="Yokoo S" first="Satoshi" last="Yokoo">Satoshi Yokoo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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