Scapular Osteocutaneous Flap

Scapular Osteocutaneous Flap


Scapular and parascapular cutaneous flaps of the back (1, 2, 3, 4, 5, 6) may be combined with the osseous territory of the lateral border of the scapula to provide versatile osteocutaneous free flaps based on the circumflex scapular artery. A wide variety of tissue combinations have been used extensively for head and neck reconstruction of both the mandible and maxilla (7) and also for reconstruction of tibial osseous defects (8).


The blood supply to the lateral border of the scapula is derived from a descending branch of the circumflex scapular artery just before its emergence through the triangular space, where it then arborizes to supply the cutaneous circulation. The distal third of the scapula is supplied additionally by the terminal branches of the thoracodorsal artery (Fig. 201.1). This anatomic relationship is important when planning osteotomies of the distal third of the scapula: If the thoracodorsal circulatory system is not included in the flap, osteotomies in the distal third risk necrosis of the bone. The entire border of the scapula, including the tip, may be well served by the proximal blood supply, provided that osteotomies in the distal third are not performed.

Only gold members can continue reading. Log In or Register to continue

Jun 26, 2016 | Posted by in General Surgery | Comments Off on Scapular Osteocutaneous Flap
Premium Wordpress Themes by UFO Themes