A new angle to mandibular reconstruction: the scapular tip free flap

Head Neck. 2013 Jul;35(7):980-6. doi: 10.1002/hed.23065. Epub 2012 Jul 30.

Abstract

Background: The purpose of this study was to review our experience with the scapular tip free flap for mandibular reconstruction, describe the surgical approach, and highlight specific clinical applications.

Methods: A retrospective review of all patients undergoing oromandibular reconstruction using a scapular tip free flap at the London Health Sciences Centre was undertaken. Patient demographics, surgical data, and early outcomes were collated.

Results: Twenty patients were identified. The majority involved mandibular angle and short segment defects (16 of 20). Average length of the segmental defect was 6.2 cm with the longest measuring 8 cm. A single patient required an osteotomy. Six were revision cases. No vein grafts were required. One complete flap failure occurred.

Conclusions: The natural scapular angle makes the scapular tip flap ideal for mandibular angle reconstruction. Short bone segments can be harvested with little donor-site morbidity. The long pedicle length may obviate vein grafts.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Free Tissue Flaps*
  • Humans
  • Male
  • Mandibular Reconstruction / methods*
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Retrospective Studies
  • Scapula / surgery*
  • Treatment Outcome
  • Young Adult