Free scapular flap for reconstruction of upper extremity defects

To determine the functional outcome of free scapular flaps performed for reconstruction of complex upper extremity defects.

Case series.

The Aga Khan University Hospital, from 1998 to 2001.

All those patients in whom free scapular flap was done for reconstruction of upper extremity defects, were included. The important variables included demographic data, etiology of soft tissue defects, site and size of defect, complications, percentage of wound coverage by flap. Patient satisfaction, objective assessment of flap and range of motion of involved joints was determined.

There were 9 males and 2 female patients with mean age of 31.54 +/- SD11.86 years. The causes of tissue defects were road traffic accident in eight cases, bomb blast injury in 2 and industrial injury in one case. Eight scapular flaps were performed to reconstruct the defects over the hand, wrist and forearm; two flaps for defects of arm and shoulder and one for elbow coverage. Average defect size was 18 cm long and 11 cm wide. Donor site was closed primarily in all cases. Based on cosmetic appearance, coverage of required defect, performance of activities of daily living and functional range of motion of involved joints, 7 cases were graded excellent and 4 cases were good.

Scapular flap provided good robust coverage, which helped to do an early reconstruction and rehabilitation in our cases. Scapular flap can be considered workhorse for reconstruction of upper extremity defects.