Fixation of Iliac Avulsion Fracture Using Additive Manufacturing Titanium Mesh after DCIA Flap Harvesting: Case Report

Abstract

Jaw defects can have a variety of causes, including tumors, trauma, and osteomyelitis. The reconstruction of jaw defects has been improved with the free flap technique and sophisticated microvascular techniques. A deep circumflex iliac artery (DCIA) flap provides a large amount of bone for the reconstruction of the mandible. However, various complications and side effects, such as abnormal hip contour, hernia, severe bleeding tendency, gait disturbance, and hypoesthesia, can occur. Iliac bone fracture is not a common complication after DCIA flap harvesting, because the anterior superior iliac spine (ASIS) can include the harvested flap. If an iliac avulsion fracture occurs, various treatment options exist. If severe dislocation of the bone fragment exists, open reduction and internal fixation are required. At this time, orthopedic implants composed of various materials can be used. Among these, when using a 3D-fabricated implant using a Ti6Al4V alloy, the accuracy of the size and shape is excellent, and it can have mechanical–biocompatible advantages. In this study, we report cases of iliac bone fracture after reconstruction of the jaw with a DCIA flap and the treatment modality using a 3D-printed, patient-specific titanium implant.