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Free latissimus dorsi flap with long venous grafts for closure of a soft tissue defect of the spine in a patient with Noonan's syndrome: A case report
Author(s) -
Sinis Nektarios,
Lanaras Tatjana Ismini,
Kraus Armin,
Werdin Frank,
Schaller HansEberhard,
Peek Alberto
Publication year - 2009
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20625
Subject(s) - medicine , surgery , latissimus dorsi muscle , soft tissue , noonan syndrome , deformity , anatomy , psychiatry
A 23‐year‐old male patient was operated for a soft tissue defect of the spine using a free musculocutaneous latissimus dorsi flap with two 21‐cm long venous grafts connecting the flap to its vascular supply at the thoracodorsal vessels. This young patient suffered from Noonan's Syndrome that is a complex hereditary malformation syndrome with clinical features often leading to spinal deformities and gibbus development. The defect originated from a former internal vertebral fixation that was necessary for erective correction of such a spinal deformity. After perforation of the introduced material and debridement the defect was 4 × 8 cm in size, which was successfully closed by the free latissimus dorsi transfer. However, two venous grafts were necessary because the extension of the pedicled muscle was not sufficient to reach the defect. This is the first case in literature where a free flap was used with two venous grafts to close a soft tissue defect of the spine in the special case of a vertebral deformity based on a Noonan's Syndrome. © 2009 Wiley‐Liss, Inc. Microsurgery, 2009.