Combined V figure‐shaped scapular osteocutaneous and latissimus dorsi myocutaneous flap for composite mandibular reconstruction

Background. As early as 1981, the scapular crest was reported as a versatile donor site of vascularized bone flap. In our institute, much attention has been paid to applying a compound flap based on the subscapular vascular system for composite mandibular reconstruction. Methods. The combined V figure‐shaped scapular osteocutaneous and latissimus dorsi myocutaneous flap has been used for primary or secondary reconstruction of the mandible, intraoral mucosa and/or external skin following major ablation of the malignant tumors in seven patients. Results. There was one total flap failure. Satisfactory results were obtained in the remaining patients. Conclusions. The V figure‐shaped scapular bone flap supplied by the angular branch provides a long rotation arc of vascular pedicle, a long bony segment of more than 14 cm, and a good contour of mental protuberance. The combination of the scapular osteocutaneous flap with latissimus dorsi myocutaneous flap allows reliable reconstruction of massive and three‐dimensional composite mandibular defects. © 1995 Jons Wiley & Sons, Inc.