OBJECTIVETo evaluate the temporomandibular joint (TMJ) function after mandible reconstruction with free fibula flap and with different condyle treatment.

METHODSForty-one cases of mandible and condyle defects following benign tumor resection were reconstructed with fibula free flap, with the condyle being reconstructed by three methods: placement of the distal end of the fibula flap into the glenoid fossa, the fibula serving as the condyle (24 cases); attachment of the resected condyle as a nonvascularized transplant to the end of the fibula flap (5 cases); condyle preservation plus vascularized fibular reconstruction (12 cases). The postoperative TMJ function was evaluated by Fricton function index.

RESULTSNo TMJ ankylosis occurred in all patients. There were no significant differences in aesthetics, deglutition and speech function among the three groups; but there were significant differences in TMJ function index (DI, CMI) among different condyle treatments. Condylar preservation showed better TMJ function than fibula used as a substitute for condyle.

CONCLUSIONSPreservation of condyle during free fibula mandibular reconstruction can improve patients' TMJ function. The location and shape of fibular condyle were important factors that could influence the outcome the condyle reconstruction.