Journal of Plastic, Reconstructive & Aesthetic Surgery
The osteomuscular dorsal scapular (OMDS) flap: an alternative technique of mandibular reconstruction
Section snippets
Anatomical study
The investigations used 13 scapulas from 13 fresh cadavers, which had been injected with coloured latex. The subclavian artery had been exposed and 50 ml of green-coloured latex was injected into it. The upper limb, including the scapula and the clavicle, were removed 2 days after the injection. The number of arterial branches running on the inner aspect of the scapula near its medial border have been noted and the following horizontal distances between the dorsal scapular artery or its branches
Anatomic study (Table 1)
The dorsal scapular artery was running in close contact to the superior border of the scapula, coming from the subclavian artery to the superior angle. Near the superior angle of the scapula, the dorsal scapular artery gave a medial branch to the levator scapulae and the rhomboid muscles, and a lateral one which ran on the anterior face of the scapula lateral to the medial border and gave small branches to the rhomboid muscles, and a very small posterior branch to the posterior face of the
Discussion
In our experience, free microvascular fibula transfer has been the preferred technique for reconstruction of mandibular defects. We present, here, an alternative method for unilateral defects, which involves pedicled transfer of an osteomuscular flap, including the rhomboid muscles and the medial border of the scapula. The point of rotation lies on the anterior border of the clavicular insertion of the trapezius. The flap reaches the condylar process cranially and the canine region ventrally.
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Modification of the pedicled osteomuscular dorsal scapula flap to include a skin paddle
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