title: A new angle to mandibular reconstruction: the scapular tip free flap.
abstract: BACKGROUND
  The purpose of this study was to review our experience with the scapular tip free flap for mandibular reconstruction, describe the surgical approach, and highlight specific clinical applications.
  
  
  METHODS
  A retrospective review of all patients undergoing oromandibular reconstruction using a scapular tip free flap at the London Health Sciences Centre was undertaken. Patient demographics, surgical data, and early outcomes were collated.
  
  
  RESULTS
  Twenty patients were identified. The majority involved mandibular angle and short segment defects (16 of 20). Average length of the segmental defect was 6.2 cm with the longest measuring 8 cm. A single patient required an osteotomy. Six were revision cases. No vein grafts were required. One complete flap failure occurred.
  
  
  CONCLUSIONS
  The natural scapular angle makes the scapular tip flap ideal for mandibular angle reconstruction. Short bone segments can be harvested with little donor-site morbidity. The long pedicle length may obviate vein grafts.
authors: Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada. john.yoo@lhsc.on.ca
authors: John
authors: J
authors: Yoo
authors: Samuel A
authors: SA
authors: Dowthwaite
authors: Kevin
authors: K
authors: Fung
authors: Jason
authors: J
authors: Franklin
authors: Anthony
authors: A
authors: Nichols
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012540:Scapula / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult