Coverage of clavicular area by a pectoralis minor pedicle flap: anatomical study and description of three clinical cases.
As the data in the literature concerning the vascularization of the pectoralis minor were conflicting, we conducted a new anatomic study on cadavers preliminary to clinical application of a pedicle flap for clavicular coverage in 3 patients. Twenty flaps were dissected, yielding numerous anatomic variations. In all cases, the principal arteries penetrated the muscle in its upper part, either posteriorly or posterolaterally. This anatomic study justified the use of the pectoralis minor as a pedicle flap, with turnover just below the coracoid process. Accordingly, 3 cases of clavicular defects were treated successfully. Reports in the literature propose an adipofascial turnover flap or a pectoralis major flap for clavicular coverage. The pectoralis minor pedicle flap is easy to dissect and reproducible, involving minor esthetic sequelae and no functional complications. This flap, which has never been described in this application, would appear to be suitable for first-line treatment in this indication.
Bourdais
Ludovic
L
Service of Plastic Surgery and Burn Unit, CHU of Nantes, Nantes, France. bourdaisludovic@gmail.com
Bellier-Waast
Frederique
F
Perrot
Pierre
P
Delpierre
Jean
J
Pannier
Michel
M
Duteille
Franck
F
D000328:Adult; D001158:Arteries / Q000033:anatomy & histology; D002102:Cadaver; D002968:Clavicle; D018223:Dermatofibrosarcoma / Q000175:diagnosis / Q000601:surgery; D004210:Dissection; D004954:Esthetics; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000033:anatomy & histology / Q000098:blood supply* / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000601:surgery; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult