title: Muscular pedicled lateral chest composite flap-a new nonmicrosurgical option for forearm salvage.
abstract: Posttraumatic upper or lower limb salvage is still challenging. Under difficult situations in which only one vessel supplies the hand or foot, free microvascular reconstruction might damage not only the transferred tissue but also the terminal hand or foot. Two cases of incomplete amputation of the unilateral forearm with large radius bone and soft tissue loss were reconstructed using a newly-refined pedicled osteomyocutaneous flap including vascularized rib, lateral part of the latissimus dorsi muscle, and skin as a lateral chest flap. After insetting of the flap, the transferred limb is fixed with a soft bandage, and the flap is divided no less than 4 weeks after the first operation. The flap completely survived, and bone union between the rib and radius was observed. Although our treatment needed a two-stage procedure, safe and secure reconstruction with an appropriate amount of tissue for salvage was accomplished.
authors.affiliation: Department of Plastic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan; Department of Plastic Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan; and Department of Plastic Surgery, School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Shiokawa
authors.affiliation: Department of Plastic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan; Department of Plastic Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan; and Department of Plastic Surgery, School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Minabe
authors.affiliation: Department of Plastic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan; Department of Plastic Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan; and Department of Plastic Surgery, School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Momosawa
authors.affiliation: Department of Plastic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan; Department of Plastic Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan; and Department of Plastic Surgery, School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Mashiko