A Pedicle Forearm Fillet Flap Aided by Subperiosteal Proximal Dissection in Shoulder Disarticulation

Combination of a Total Free Forearm Flap and a Sensate Local Flap for Preservation of the Shoulder Girdle in Massive, Nonreplantable Upper Extremity Injuries

“…[5][6][7][8][9][10][11] A partial preservation of the shoulder girdle has significant advantages in addition to minimizing the disfigurement. 3 The bony prominence improves fitting and use of a functional myoelectric prosthesis. 3,12 The weight discrepancy between both upper extremities is reduced, potentially minimizing late sequelae such as the formation of a scoliotic deformity.…”

“…3 The bony prominence improves fitting and use of a functional myoelectric prosthesis. 3,12 The weight discrepancy between both upper extremities is reduced, potentially minimizing late sequelae such as the formation of a scoliotic deformity. Preservation of a functional shoulder girdle musculature is also beneficial in regard to overall function and respiration.…”

“…1,2 As a reconstruction of the shoulder contour with myocutaneous or osteomyocutaneous free flaps is not only technically very demanding and may require the sacrifice of functionally significant structures but also shows unpredictable long-term results, a partial preservation of the shoulder girdle should always be attempted. 3 Soft tissue coverage of the remaining defects remains challenging. Chest wall defects often require not only free tissue transfer, but sensate tissue is preferable to cover bony prominences to minimize late sequelae such as pressure ulceration.…”