Summary
The vascularised scapular bone free flap is popular in mandible reconstruction, but
it is less commonly used as a pedicled flap to reconstruct the upper humerus. We analysed
our experience with pedicled scapular crest flaps in humerus reconstruction and compared
our results with cases reported in the literature. We considered the age at surgery,
the time elapsed before reconstruction, the time required to obtain solid bony union,
the operative indication, the osteosynthesis procedure used and whether circumflex
scapular vessels or angular vessels were used. There were eight patients (seven men
and one woman, mean age=33): four humerus stump lengthenings, two upper-third humerus bone and soft tissue
defects and two multioperated established humerus non-unions. Flaps were pedicled
either on circumflex scapular vessels (three) or angular vessels (five). The mean
size of the scapular bone used was 9.4 cm (range 7–11 cm). We associated a covering flap for seven patients. All the flaps survived and
bone healed in a 3.75 month mean delay (range three to six months), and there was
one accidental secondary fracture one year after reconstruction. For a vascularised
reconstruction of the upper humerus, the pedicled scapular bone flap is a valuable
option especially if a composite reconstruction is needed. For short humerus stump
lengthening, this flap seems to provide a very satisfactory solution.
Keywords
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References
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Article info
Publication history
Published online: May 11, 2007
Accepted:
March 27,
2007
Received:
June 2,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
