Purpose statement: Osseous microvascular reconstruction is the mainstay of treatment for mandibular defects. In the literature discussing the various techniques of reconstruction there has been little written with regard to the bone to bone contact areas. The greater the contact surface area, the higher the likelihood of subsequent bone fusion. This paper examines the use of the scarf joint to maximize surface contact and facilitate bone fusion.

Methods and materials: A retrospective review of 20 microvascular reconstructions of the mandible. Of these patients 7 underwent the lapped scarf joint technique of bone to bone contact in the mandible.

Results: Six out of the seven patients had adequate osseous ingrowth with no major complications. In one patient, there was failure of bone fusion due to a hardware failure. This patient had a full course of postoperative radiation. Six of the seven patients had good boney fusion with evidence of callous formation at the junction of the mandible and the fibula.

Conclusions: Although only a small number of patients were examined, the scarf joint technique seems to facilitate bony fusion. The one complication was due to hardware failure and went on to fusion after further revisional surgery.