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Case Reports
. 2021 Aug 11;8(1):118-120.
doi: 10.1080/23320885.2021.1962717. eCollection 2021.

Combined iliac crest graft and short-scar pectoralis major flap for clavicular non-union reconstruction

Daniel Sattler  1 , Hans-Philipp Springorum  1 , Rafael Maria Armbruster  1 , Maria von Kohout  1 , Armin Kraus  2
Affiliations
Case Reports

Combined iliac crest graft and short-scar pectoralis major flap for clavicular non-union reconstruction

Daniel Sattler et al. Case Reports Plast Surg Hand Surg. .

Abstract

Recently, we reported defect coverage in the clavicular region with a scar-sparing pectoralis major flap. We successfully combine this flap with a clavicular reconstruction by an iliac bone graft for non-union now. We propose this reconstructive combination for cases of clavicular non-union with lack of soft tissue coverage.

Keywords: Reconstructive surgery; head and neck; scar.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Soft tissue defect and clavicular non-union after repeated debridements and vacuum dressings. Bone defect was filled with antibiotic beads.
Figure 2.
Figure 2.
Interposition of a 4 cm iliac crest graft and fixation by a locking plate.
Figure 3.
Figure 3.
Coverage of the bone graft and the locking plate by a pectoralis major flap elevated via a short scar submammary incision.
Figure 4.
Figure 4.
X-ray imaging 8 weeks after surgery shows good embedding of the bone graft and regular plate and screw positions.
Figure 5.
Figure 5.
Postoperative result after 8 weeks: good defect coverage, inconspicuous scar and only minor impairment of the chest form can be observed.
See this image and copyright information in PMC

References

    1. Sattler D, Kohout MV, Kraus A.. Short-scar pectoralis major flap through a submammary fold incision. Arch Plast Surg. 2019;46(5):486–487. - PMC - PubMed
    1. Schnetzke M, Morbitzer C, Aytac S, et al. . Additional bone graft accelerates healing of clavicle non-unions and improves long-term results after 8.9 years: a retrospective study. J Orthop Surg Res. 2015;10:2. - PMC - PubMed
    1. Kirchhoff C, Banke IJ, Beirer M, et al. . Operative management of clavicular non-union: iliac crest bone graft and anatomic locking compression plate. Oper Orthop Traumatol. 2013;25(5):483–498. - PubMed
    1. Beirer M, Banke IJ, Harrasser N, et al. . Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft. BMC Musculoskelet Disord. 2017;18(1):129. - PMC - PubMed
    1. Wei F-C, Mardini S.. Flaps and reconstructive surgery. 2nd ed. London: Elsevier; 2016.

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