Pedicle Scapular Apophysis Transplantation in Congenital Limb Malformations

Free Flap Transfer for Pediatric Head and Neck Reconstruction: What Factors Influence Flap Survival?

“…Although the scapula, fibula, and iliac crest are all excellent choices for mandibular reconstruction, the fibula was the most common osseous flap (97 of 101, 96.0%) used. The scapula has lower donor site morbidity in a child, 19,32 and the scapular tip apophysis may offer greater remodeling potential. 19,24,32 However, in our study, the length of the mandibular defect was greater than 10 cm in 80% of cases; thus, the bone length of a scapular flap was insufficient.…”

Reconstruction of the Pediatric Maxilla and Mandible

“…A smaller but equally important growth plate exists superiorly, adjacent to the glenoid fossa. 16 Mainly responsible for vertical scapular growth, the superior growth plate lies outside the range of harvested bone, and therefore should not be directly affected. Both superior and inferior growth plates fuse at age 20 resulting in a disruption of the normal scapular development by harvesting bone from the lateral border of the scapula in the pediatric patient.…”

“…The lateral border of the scapula serves as a traction epiphysis, growing in response to pull of the teres and triceps muscle groups. 14 Teot et al 16 found that harvesting bone from this area for congenital limb reconstruction resulted in a moderate scapular size discrepancy, but no appreciable functional deficit. They concluded that the upper growth plate compensates for disruption of the lateral scapular border, although there is no objective data to support this claim.…”

Microvascular cricoid cartilage reconstruction with the thoracodorsal artery scapular tip autogenous transplant

“…2 and 3), which can occur with other osseous donor sites such as the lateral border of the scapula and the fibula. This may be because the curved natural shape of the scapula tip was contoured along embryologic growth planes,10 which does not occur when the aforementioned osseous donor sites are used for cricoid reconstruction.…”