{"doi":"10.1002/hed.28214","title":"Predictors and Implications of Bony Union of Osseous Free Flaps for Oromandibular Reconstruction","abstract":"BACKGROUND: Optimal contouring of osseous free flaps for mandibulectomy often requires osteotomies. The impact of malunion or nonunion on hardware extrusion is not well-documented. This study assesses postoperative bony union, its correlation with plate extrusion, and related demographic and surgical predictors. METHODS: A retrospective study of 127 patients who underwent segmental mandibulectomy and osseous free tissue transfer from 2004 to 2019. Bony union was assessed via computed tomography (CT) scans at 6-9, 9-15, and 15-24 months using a callus scale. Logistic regression analyzed the relationship between bony union, hardware extrusion, and various factors. RESULTS: Radiographic nonunion rates at 6-9, 9-15, and 15-24 months were 24.8%, 20.4%, and 13.2%, respectively. Nonunion at 9-15 months (OR = 3.67) and 15-24 months (OR = 1.80) significantly increased hardware extrusion risk. Lower bony union was linked to prior radiation, alcohol use, perioperative complications, and thinner plates. CONCLUSIONS: Bone union after oromandibular free-flap reconstruction is affected by radiation, perioperative complications, and smoking. Fibular and scapular transfers had similar outcomes. Further long-term studies are needed to enhance reconstruction techniques.","journal":"Head & Neck","year":2025,"id":526084,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9557,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":390568,"name":"Rami W. Eldaya","orcid":"0000-0001-7801-1015","position":1,"is_corresponding":false},{"id":390566,"name":"Hilary L.P. Orlowski","orcid":"0000-0002-3141-0892","position":2,"is_corresponding":false},{"id":693473,"name":"Craig A. Bollig","orcid":"0000-0002-9514-5338","position":3,"is_corresponding":false},{"id":348696,"name":"Jake J. Lee","orcid":"0000-0002-8175-9486","position":4,"is_corresponding":false},{"id":693444,"name":"R. Alex Harbison","orcid":"0000-0002-4695-6142","position":5,"is_corresponding":false},{"id":231258,"name":"Paul Zolkind","orcid":"0000-0002-9475-1686","position":6,"is_corresponding":false},{"id":231263,"name":"Ryan S. Jackson","orcid":"0000-0003-4626-2324","position":7,"is_corresponding":false},{"id":60989,"name":"Sidharth V. Puram","orcid":"0000-0003-3543-889X","position":8,"is_corresponding":false},{"id":231264,"name":"Patrik Pipkorn","orcid":"0000-0002-4118-7743","position":9,"is_corresponding":false},{"id":693472,"name":"Amit Walia","orcid":"0000-0002-1061-0561","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-19T02:50:25.860105Z","pmid":"40557544","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}