Functional reconstruction of the temporomandibular joint with a free fibular microvascular flap.

By preserving the temporomandibular joint (TMJ) disc in the glenoid fossa at the time of resection, correctly securing the vascularised fibular end in the fossa, and by reattaching the lateral pterygoid muscle, it is possible to maintain normal rotation, translatation, and protrusion in the TMJ and the function of the jaw can be totally restored. We describe four patients in whom good function was achieved in three; this is underlined by extensive remodelling of the condylar head seen at radiological follow-up up to 36 months.