Outcomes of Anatomic Reconstruction of Gunshot-Inflicted Lower Face Defects by Free Osteoseptocutaneous Fibula Flap and Expanded or Nonexpanded Temporal Scalp Flap Combination in Males

The study involved 7 male patients who had sustained gunshot injuries to the lower face and underwent reconstruction with a free osteoseptocutaneous fibula flap (FOCF) for the mandibular defect and a temporal scalp flap for facial skin, with an average follow-up of 3.5 years. All FOCFs survived, and despite complications with expander exposition in 2 cases of pre-expanded flaps, all patients achieved acceptable functional and aesthetic outcomes. The study concluded that the FOCF and scalp flap combination is effective for reconstructing lower face defects, with pre-expansion of the scalp flap potentially reducing donor area morbidities. The procedure was found to be reliable and provided good long-term results, although the study was limited by its small sample size and the additional operations required for expanded flaps.