Options for Configuring the Scapular Free Flap in Maxillary, Mandibular, and Calvarial Reconstruction

Abstract

The authors have found the scapular free flap to be a reliable, robust, and versatile flap that provides an unparalleled range of reconstructive options, with minimal donor-site morbidity. Thus, the authors believe that the scapular free flap is a valuable reconstructive option for patients with complex head and neck defects and in patients in whom comorbid disease contraindicates the use of the fibular free flap.

Osseointegrated implants into a variety of composite free flaps: A comparative analysis

“…It is important to take into consideration the highly selected nature of flap choice and site of implant placement. In particular, for scapula flaps, the variable thickness and density of the lateral border means that planning is critical to make sure that suitable bone is available preoperatively and is correctly positioned before flap inset …”

“…In particular, for scapula flaps, the variable thickness and density of the lateral border means that planning is critical to make sure that suitable bone is available preoperatively and is correctly positioned before flap inset. 17 Bone irradiation and implant survival has been studied extensively and to date have shown no increase in failure in irradiated bone. 5 In our series, there was no statistical difference observed in the failure rate of all implants placed, however, we suspect this may be due to inadequate sample size.…”

Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years

“…The four main flap donor sites were the fibula with 6178 flaps (8, 12, 16-18, 20-22, 24, 26-28, 32-55, 57-59, 61-64, 66-, 79, 81-83, 85, 87-89, 93, 94, 96-104, 106, 108 -131, 131, 133, 135, 137-141, 143, 145-154, 156, 158-169, 171-175, 179-184, 186-193, 195, 196, 198-200, 202-207, 209, 210, 212-216, 218-223, and 225-229), the iliac crest with 1380 flaps (8, 12-15, 17-20, 26, 29,31, 36, 38, 41, 45, 48, 50, 53, 54, 57-60, 62, 63, 65, 67, 72, 74, 75, 77, 79, 83, 84, 86, 87, 92, 96, 98, 99, 102, 105, 112-115, 121, 132, 149, 151, 152, 155, 157, 158, 161, 168, 170, 171, 173, 174, 177, 178, 181, 183, 186, 201, 211, 212, 216, 219, 227), composite radius with 1127 flaps (8, 10-12, 17, 20, 23, 25, 30, 32, 33, 48, 50, 56, 62, 67, 72, 75, 77, 80, 85, 87, 91, 93, 95, 96, 98, 99, 104, 113, 114, 133, 150, 152 154, 165, 176, 180, 183, 185, 203, 213, and scapula with 709 flaps (8,9,12,14,17,26,32,45,46,48,50,53,58,59,63,67,70,74,77,85,87,90,93,96,99,113,114,134,136,142,144,151,156,169,172,189,191,194,…”

52 Mandibular Reconstruction and Osseointegrated Dental Implants

“…69 For immediate mandibular reconstruction, the scapular flap provides short-term results equivalent to those with a fibular flap but with less donor site morbidity. The major drawbacks of the fibular flap include prolonged healing of the donor site and the delayed mobilization of patients.…”