Development of the iliac crest microsurgical free flap has greatly improved the surgical reconstruction of oromandibular defects. A decade of continuous utilization has established its efficacy and versatility. The utility of the flap has been continuously expanded by the introduction of new surgical techniques and adjunctive innovations. The advent of improved internal fixation systems, osteointegration, and neurocutaneous flaps has facilitated a more comprehensive oromandibular rehabilitation. The introduction of the split inner-cortex modification by the principle author served to refine the bony component and greatly reduces postoperative complications and donor site morbidity.
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