Although the circumflex scapular artery is usually accompanied by two venae commitans, the subscapular artery is typically accompanied by one vein. The parascapular flap is oriented vertically, from the triangular space to a point midway between the tip of the scapula and the iliac crest. More specifically, the upper back extends superiorly from a line joining the spinous. Osteofasciocutaneous parascapular flap transfer for reconstruction of the first ray of the foot article pdf available in archives of orthopaedic and trauma surgery 1288. The scapular flapan anatomical and clinical study journal of. Pdf subscapularis muscle flap for reconstruction of. Finally, it can be designed as a bonemuscle flap by combining the scapula tip based.
This is a composite flap that is situated over the scapula with various incisional arrangements. Anterior capsular reconstruction for irreparable subscapularis tears jonas pogorzelski, m. Scapular bone flap harvests of patients in a supine position. Medical definition of interthoracoscapular amputation. Planning it eccentrically allows the flap to reach up to the lower third of the arm comfortably. Bilateral unexpanded supraclavicular flaps for singlestage. After performing several free style flaps, the technique and the entire. Subscapular system free flap reconstruction in the. The parascapular branch forms the basis of the parascapular flap. The parascapular flap provides a fasciocutaneous flap with similar characteristics to those of the scapular flap. Parascapular flap an overview sciencedirect topics. The parascapular flap design almost completely overlaps an oblique design of the. The morbidity from harvesting these flaps is minimal and they are very useful for reconstruction in pediatric patients.
Ta the area of the back corresponding to the outlines of the scapula. This combination allows the creation of an extremely large cutaneous flap from the dorsal thorax while ensuring survival of both the muscle and skin. The subscapular artery pedicle can be from 3 to 7 cm in length with vessel circumference at this level up to 4 millimeters in size. How to strengthen periscapular muscles answers on healthtap. It is under the dependence of a direct cutaneous artery that is a vertical terminal branch of the circumflex scapular. Supraclavicular flap for head and neck reconstruction vula. Bhanu prakash usmle, fmge and neet pg 67,594 views. The free scapulaparascapular flap is a versatile and reliable flap that can find many applications in the reconstruction of complex head and neck defects.
In 1978, saijo was the first to describe the scapular fasciocutaneous flap anatomy based on the circumflex scapular artery csa. The combined parascapular fasciocutaneous and latissimus. The descending branch of the circumflex scapular artery. Scapular region definition of scapular region by medical. Request pdf on jul 1, 2004, toshiro nishimura and others published scapular bone flap harvests of patients in a supine position find, read and cite all the. The flap is highly reliable and since the procedure is shorter than free flap recon. The flaps available include the scapular flap, parascapular flap, serratus anterior flap, and latissimus dorsi flap, which can be used individually or in a combined manner to reconstruct extensive defects. The other problem with this flap is that the patient has to be placed in the lateral decubitus position. In addition, a scapular or parascapular septocutaneous flap served by the.
Arterial anastomosis around the scapula upper limb gross anatomy usmle step 1 videos duration. The vascular pedicle length from the origin of the vascular pedicle to its entry into the skin flap of anterolateral thigh flap. A variant of the parascapular flap is the inframammary extended circumflex scapular imecs flap, in which the axis of the flap is rotated anteriorly, across the lateral chest and into the inframammary fold. Ligating the horizontal branch allows a further mobilization of the pedicle by 23 cms. Pdf osteofasciocutaneous parascapular flap transfer for. Scapularperiscapular exercises table slides abduction 2 x 10 slide arm and body together across table.
The scapular parascapular system of flaps is a unique system of flaps available for free tissue transfer based on the subscapular artery and its branches. The parascapular fasciocutaneous and latissimus dorsi muscle flaps can be raised together as a clinical example of a branchbased common conjoined flap. Supraclavicular flap is an accepted modality for neck scar. The anatomy of the parascapular flap allows it to be harvested with a large number of other flaps on a single pedicle. Anatomical comparison among the anterolateral thigh, the. The flap is a good asset for the surgeon, as it is versatile and can correct multiple types of defects. The flap can be larger in width than the scapular flap, approaching 15 cm and has been harvested as long as 25 cm. Planks are best, followed by yoga and traditional situpscrunches.
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