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

Area of Science:

• Reconstructive surgery
• Oral and maxillofacial surgery
• Microsurgery

Background:

• Mandibular defects present significant reconstructive challenges.
• Free flap reconstruction is a common approach for oromandibular defects.
• The scapular tip free flap is a viable option for specific mandibular reconstructions.

Purpose of the Study:

• To review the authors' experience with the scapular tip free flap for mandibular reconstruction.
• To describe the surgical technique and approach for this flap.
• To highlight the clinical applications and outcomes of the scapular tip free flap.

Main Methods:

• Retrospective review of patients undergoing oromandibular reconstruction.
• Utilized the scapular tip free flap at London Health Sciences Centre.
• Collected patient demographics, surgical data, and early outcomes.

Main Results:

• Twenty patients were included in the review.
• Most reconstructions (16/20) involved mandibular angle and short segment defects.
• Average defect length was 6.2 cm; one complete flap failure occurred, and no vein grafts were needed.

Conclusions:

• The scapular tip free flap's natural angle is ideal for mandibular angle reconstruction.
• Short bone segments can be harvested with low donor-site morbidity.
• The long pedicle length frequently eliminates the need for vein grafts.