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[Osteomusculocutaneous flap for clavicular reconstruction: a case report]
Mustafa Yel1, M Nazim Karalezli, Zekeriya Tosun
1Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Selçuk University, Konya, Turkey. myel@selcuk.edu.tr
Acta Orthopaedica Et Traumatologica Turcica
|May 8, 2007
Summary
This study presents a successful treatment for a clavicle fracture caused by radiation therapy. A rib-latissimus dorsi osteomusculocutaneous flap restored bone integrity and improved shoulder function.
Area of Science:
- Orthopedic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Radiotherapy for cancer treatment can lead to complications such as soft tissue necrosis, osteonecrosis, and pathologic fractures.
- Pathologic fractures, particularly in the clavicle, pose significant challenges in reconstruction due to the proximity of vital structures and the need for functional restoration.
Observation:
- A 47-year-old female patient developed a pathologic fracture of the left clavicle 10 years post-radiotherapy for breast cancer.
- The fracture resulted in significant pain and functional limitation of the left shoulder.
Findings:
- The patient underwent surgical reconstruction using a compound rib-latissimus dorsi osteomusculocutaneous flap, incorporating a 4-cm segment of the sixth rib.
- Bone fusion was successfully achieved within three months.
- Postoperative recovery demonstrated cosmetically acceptable donor site morbidity and marked improvement in shoulder function, evidenced by an increase in the Constant shoulder score from 36 to 88 over 38 months.
Implications:
- This case highlights the efficacy of osteomusculocutaneous flap reconstruction for complex post-radiation clavicular defects.
- The technique offers a viable solution for restoring structural integrity and functional outcomes in patients with radiation-induced bone damage.
- Further research could explore long-term outcomes and variations of this reconstructive approach.