Assessment Of The Effect Of Fibula Flap With Flexor Hallucis Longus On Head And Neck Tumor Patients' Quality Of Life And Function Of Donor Site:a Comparative Study With Fibula Flap Without Flexor Hallucis Longus

Objective:Fibula free flap(FFF)has been widely used in the reconstruction of oral and maxillofacial defect.It is one of the workhorse flap for reconstruction.Whether to retain the flexor hallucis longus(FHL)into flap hasn't reached an agreement.There is few reports about the influence on Patients' postoperative quality of life and donor site after excision of FHL.This study introduces the contrast study about retaining flexor hallucis longus or not in FFF of head and neck tumor patients to observe the impact on patients' quality of life and function of the legs.Methods:We chose patients who underwent FFF in our hospital from 2017.2 to 2018.6,randomly assigned them into FHL group(15 patients)and n FHL group(15 patients).Patients' hospitalization information and intraoperative information,donor-site morbidity were recorded,and patients were followed up for preoperative and postoperative 1,3 and 6 months through subjective evaluation(SF-36/AOFAS)and objective evaluation(muscle strength and angle of motion)to evaluate patients' quality of life and function of the legs.Results:The flap harvesting time in the FHL group was shorter significantly than n FHL group.There were no significant differences in hospitalization information such as operation time,hospitalization days and cost.Donor-site morbidity at postoperative 1,3 and 6 months showed no significant difference except for claw toes.The incidence of claw toes in the FHL group was significantly lower than n FHL group.There were no significant differences in SF-36 and AOFAS scores between the two groups in the subjective evaluation at 1,3 and 6 months after surgery.In objective evaluation,there were no significant differences in thumb muscle strength and angle of motion,ankle joint's angle of motion and isokinetic muscle strength.Conclusion:The excision of FHL can save flap harvesting time,and relieve the emergence of postoperative claw toe.It didn't increase donor-site morbidity.The impact on patients' quality of life and function of the legs were same.The clinicians can use FHL without considering the influence on the patients.