Chimeric partial scapula and latissimus dorsi muscle flap for midfoot reconstruction: A case report

Chen, Cha-Chun; Lin, Chi-Huwang; Lin, Yu-Hsien

doi:10.1002/micr.22033

Cited by 12 publications

(11 citation statements)

References 22 publications

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“…Scapular donor site anatomy has been extensively described in the literature, and the versatility of the scapular system has been confirmed for harvesting of chimeric flaps . The STFF provides further advantages compared to other scapular and parascapular bone‐containing free flaps.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of mandibular defects using the scapular tip free flap

et al. 2014

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Low morbidity, early ambulation time, possibility of simultaneous harvesting with the tumor resection, large musculocutaneous paddles in the chimeric version of the flap are advantages of the STFF and makes it a good choice in elderly patients, when other bone containing free flaps are not indicated because of the related morbidity, when other flaps are not available or when wide composite defects are approached.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of mandibular defects using the scapular tip free flap

et al. 2014

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“…Vascularized composite fibula, iliac crest, and scapula free flaps are preferred for the aesthetic and functional reconstruction of complex oromandibular and craniofacial defects, and also reconstruction of defects in many other regions . Bulky myocutaneous flaps can provide volumetric restoration, but a sufficient bony framework is often necessary for successful reconstruction, both to prevent wound contracture and to restore facial contours.…”

mentioning

confidence: 99%

Morphological and morphometric evaluation of the ilium, fibula, and scapula bones for oral and maxillofacial reconstruction

Shahrak

Zor²,

Kanatas

et al. 2014

Microsurgery

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This study aimed to evaluate the osteometric boundaries of the ilium, fibula, and scapula beyond which reconstruction of oromandibular and craniofacial defects, using these free flaps, may not be optimal. Fibula, scapula, and iliac bones were obtained bilaterally from 33 female and 27 male European adult cadavers (n = 60). Adapting classical anthropometric methods to surgical needs by modifying the measuring bone localizations and measurement points, a measuring system of osteometry and morphometry was used, to quantify the usable bone length of the iliac crest, fibula, and lateral border of the scapula and to localize an oval region (OR) in the ilium. The thin, translucent OR of ilium was localized 62.4 ± 5.6 mm posterior to the maximum concavity between the anterior superior (ASIS) and anterior inferior iliac spine and 26.7 ± 6 mm caudal to the intermediate line of the iliac crest. The available iliac crest was measured from ASIS to the posterior superior iliac spine (PSIS) 247.5 ± 12.6 mm, fibula supplied 170.2 ± 19.1 mm harvestable bone, and the lateral border of the scapula 94.3 ± 8.5 mm [Corrected]. The OR influenced the harvestable bone shape and volume of the ilium. Measuring of the localization points of OR, we found that the size of the OR was very variable and that the height of the neomandible reconstructed with iliac crest might alter with aging. Our findings contribute with knowledge of detailed morphometric measurements on commonly used donor bones to the planning strategies of volumetric defects in oral and maxillofacial region by precise osteometric localization method of OR and relativized length measurements.

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“…Scapular osseous free flaps are often used for simultaneous or secondary reconstructions after cancer ablation or traumatic injuries. 7,8 When combined with other flaps involving the subscapular artery system, 9,10 such as the TAP flap, parascapular flap, 11 latissimus dorsi flap, 12 and serratus flap, 13 bony and soft tissue reconstruction can be achieved using a single procedure. 8,9,14,15 Scapular flaps that are nourished by an angular branch of the thoracodorsal artery have relatively long pedicles (from 10 to 16 cm) 4-6 compared with other osseous flaps, such as the fibula flap, 16 iliac flap, and scapular flaps nourished by the circumflex scapular artery.…”

Section: Discussionmentioning

confidence: 99%

Lengthening the pedicle of a scapular osseous free flap by angular branch reconnection within the subscapular artery system

et al. 2014

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This report describes a case of a patient who underwent secondary reconstruction of the maxilla using a combined scapular osseous and thoracodorsal artery perforator (TAP) flap, in which the pedicle of the scapular osseous flap was lengthened by reconnecting the angular branch of the thoracodorsal artery to the serratus branch. The patient was a 62-year-old man who had undergone left total maxillectomy for maxillary carcinoma and came for reconstruction of left deformity. A reconstructive procedure involving a vascularized scapular osseous and TAP flap transfer was planned. However, the patient's ipsilateral superficial temporary artery and facial artery was found stenosed due to previous radiotherapy and chemotherapy and were not suitable for use as recipient vessels. Thus, a long flap pedicle was needed for anastomoses to the contralateral recipient vessels. We lengthened the pedicle of the scapular osseous flap by reconnecting the angular branch of the thoracodorsal artery to the serratus branch within the chimeric free flap and then anastomosed it to the contralateral facial vessels. The postoperative course was uneventful, and the left cheek deformity was well corrected. Using the technique of reconnection of branches within the blood supply system, a chimeric flap with a long pedicle may be elevated safely whilst avoiding the need for vein grafts.

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Chimeric partial scapula and latissimus dorsi muscle flap for midfoot reconstruction: A case report

Cited by 12 publications

References 22 publications

Reconstruction of mandibular defects using the scapular tip free flap

Reconstruction of mandibular defects using the scapular tip free flap

Morphological and morphometric evaluation of the ilium, fibula, and scapula bones for oral and maxillofacial reconstruction

Lengthening the pedicle of a scapular osseous free flap by angular branch reconnection within the subscapular artery system

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