title: [Forearm osteomusculocutaneous free filet flap for arm reconstruction after amputation as an alternative to shoulder disarticulation].
abstract: We report the case of a 55-year-old woman suffering from a type I neurofibromatosis (also known as Von Recklinghausen neurofibromatosis) who was diagnosed with a high-grade schwannosarcoma of the median nerve, between the upper third and the medium third of the arm, upon contact with the humerus, invading the humeral vessels. The oncologic treatment of this tumour consisted in the amputation of the arm through the surgical neck of the humerus. In order to create a laterothoracic claw, to bring a partial function of the upper limb back, we decided to realize a free fillet forearm flap. This composite flap was composed of the radius and the ulna, all the forearm muscles and the skin of the anterior side of the forearm. A humeroradial plate osteosynthesis was done and the flap was then harvested with the radial pedicle, and anastomosed to the axillar artery. This procedure gave our patient a functional stump, giving back the arm functionality, especially the claw movement.
authors.affiliation: Service de chirurgie plastique-brûlés, Centre François-Xavier-Michelet, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. Electronic address: evagachie@live.fr.
authors.forename: E
authors.initials: E
authors.lastname: Gachie
authors.affiliation: Service de chirurgie plastique-brûlés, Centre François-Xavier-Michelet, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Alet
authors.affiliation: Service de chirurgie plastique, reconstructive et esthétique, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: P
authors.initials: P
authors.lastname: Nguyen
authors.affiliation: Service de chirurgie plastique, reconstructive et esthétique, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: C
authors.initials: C
authors.lastname: Della Volpe
authors.affiliation: Service de chirurgie plastique, reconstructive et esthétique, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: D
authors.initials: D
authors.lastname: Casanova
mesh_terms: D000671:Amputation, Surgical; D005260:Female; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008475:Median Nerve / Q000601:surgery*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D009456:Neurofibromatosis 1 / Q000150:complications; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology / Q000601:surgery*; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*
keywords: Désarticulation d’épaule; Forearm free flap; Free filet flap; Lambeau libre antébrachial radial; Membre banque; Neurofibromatose; Neurofibromatosis; Sarcoma; Sarcome; Shoulder disarticulation