• Once the extent of bone to be removed is determined, an accurate template is made in 3 dimensions. This can be done preoperatively in selected cases and a 3D printed model based on scans.
• Using the template, a similar length and shape of bone is then marked out on the appropriate donor site [this could be the leg, hip or elsewhere]
• This bone is then carefully raised along with its blood vessels and overlying skin and soft tissue as needed. This is called a composite flap.
• This flap is then inset into the defect and fixed with a titanium plate and screws. The skin and soft tissues are also inset as required
• The blood vessels are then connected to similar calibre vessels in the neck region using ultra small sutures with the aid of magnification usually with a microscope.
• The donor site is then closed or covered with a thin skin graft.