[Microsurgical scapula transplants for reconstruction of the facial skull--experiences with 44 patients]

Great versatility gives composed scapular flaps a particular significance for the reconstruction of defects in face and skull: According to individual requirements one up to five separate elements may be transferred with one vascular pedicle. Anatomical studies of 120 scapulas measured a mean length of 13.4 cm and a mean diameter of 1.2 cm of the lateral margin offering sufficient bone for most indications in the visceral skull. Up to three cutaneous flaps may cover nearly every defect in the head. 44 patients were treated in the years 1989 to 1993 using scapular flaps, most of them combinations consisting of bone and skin elements. In two patients a so called 4-in-1-flap was transferred including the latissimus-dorsi-flap. All donor sites could be closed primarily. Venous thrombosis caused one loss of a flap. Infections healed without sequelae. Medical gymnastics brought full rehabilitation of the donor site within 6 months.