Comparative study of three kinds of fibula cutting guides in reshaping fibula for the reconstruction of mandible: An accuracy simulation study in vitro

Objectives In order to get predictable reassembling and higher accuracy in the reconstruction of the mandible, we designed three kinds of fibula cutting guides: (1) Two-edge wide groove guide (WGG); (2) Two-edge narrow groove guide (NGG); and (3) One-edge guide (OEG). The purpose of this study was to compare the accuracy of fibula remodelling using the three kinds of fibula cutting guides above in a simulation procedure in vitro. Materials and methods Cutting and reshaping of fibula analogs were guided by the three kinds of guides mentioned above. Then the fibula segments were glued together and scanned with CT, and finally the 3D accuracy of fibula reshaping was compared to the virtual plan. Results Comparisons were made with regard to planned versus actual fibula segment length and angle projections in 3 planes. There were no significant differences in length change among the WGG group, NGG group and OEG group. There were very significant differences in angle projections in 3 planes between every 2 of the 3 groups. Conclusions 3 kinds of guides do not affect the length of fibula segments. Two-edge narrow groove guides (NGG) caused the smallest error among the 3 kinds of guides. The error caused by two-edge wide groove guide (WGG) was similar to that caused by one-edge guide (OEG). The conclusion was in consistent with the referred groove-restriction-effect in the section of discussion. Clinical relevance We suggest that the two-edge narrow groove guide (NGG) is the superior choice for fibula cutting in reconstruction of the mandible.