Application of serratus anterior muscle flap transfer in lateral part deformity of expander to implant breast reconstruction / 中华医学美学美容杂志

Objective To explore the application and clinical significance of serratus anterior muscle flap transfer in correction of lateral part deformity of expander to implant breast reconstruction.Methods Six patients who received expander-to-implant breast reconstruction were enrolled.After silicone implant replacing the tissue expander,all 6 cases represented lateral part deformity of the reconstructed breast.The turn-over serratus anterior muscle flap was used as lateral coverage of the deformed breast.Results Of all patients (6 cases),breast aesthetics were improved with incisions well-healed.There were no complications such as capsular contracture,hematoma,infection or insicional dehiscence.Conclusions Serratus anterior muscle flap can provide sufficient lateral coverage for expander-to-implant breast reconstruction.It is safe,simple and cheap to apply in improving the aesthetics of breast reconstruction.

Lesiones del nervio torácico largo de Bell. Revisión de conceptos terapéuticos / Long thoracic nerve of Bell. Review of therapeutic management

Las lesiones del nervio torácico producen parálisis del serrato anterior y originan una deformidad característica (escápula alata), que genera debilidad y alteraciones importantes en la movilidad del hombro. En esta revisión, se analizan conceptos sobre anatomía, etiología, presentación clínica y alternativas terapéuticas.

The long thoracic nerve injuries are manifested by a characteristic deformity called scapula alata, causing weakness, and impaired shoulder mobility. In this review current concepts of the anatomy, etiology, clinical presentation and therapeutic management are analyzed.

Treatment of Scapula Fractures of the Inferior Angle Causing Pseudowinging Scapula / 대한정형외과학회잡지

Nonoperative treatment of scapular body fractures has shown good clinical results. Although scapula fractures of the inferior angle, particularly with oblique lines from the medial proximal to lateral distally, are very rare, we believe that such a fracture pattern would be regarded as an avulsion fracture of the serratus anterior muscle requiring surgery. We have experienced three cases demonstrating pseudowinging of the scapula due to displacement of the inferior angle fracture of the scapula. Surgical repair or plating showed satisfactory clinical results. Through these cases, we describe the cause of winging scapula and the problems resulting from an avulsion fracture of the serratus anterior muscle with a review of the relevant literature and explain the reason that an operation is needed for this fracture pattern.

Reconstruction of soft tissue defects using free serratus anterior muscle and adifofascial flap

The optimal reconstruction of soft tissue defects with exposure of blood vessel, nerve, tendon muscle, and bone requires muscle flap that provides a durable surface, appropriate bulk and stability. The serratus anterior muscle has been suggested as a versatile and reliable flap for reconstruction of head and neck and extremity injuries. In our department, reconstructive operations were performed for 18 patients who had soft tissue defect of upper or lower extremities or head from March 1995 to February 1996. We performed free flap of serratus anterior muscle in 13 patients, free flap of adipofascial tissue overlying serratus anterior muscle in 3 patients, free flap of both serratus anterior muscle and adipofascial tissue in 1 patient, free flap of serratus anterior muscle and rib in 1 patient. Their ages were 5 to 56 years, the ratio of male to female was 14 : 4. The defects involved the upper extremity in 6 patients, lower extremity in 10 patients, and scalp in 2 patients. Free flap using adipofascia overlying serratus anterior muscle was performed when gliding surface was required due to the exposure of some structure such as tendon. The average duration from operation to follow-up examination was 4 months(from 1 to 12 months). One total necrosis was observed in the patient who had crushing injury of forearm, and one partial necrosis was observed in other patient. In the rest 16 cases, results of operation were satisfactory. This kind of flap was very useful in reconstruction of soft tissue defect and gliding surface due to easy dissection, capability of getting long vascular pedicle, and no serious functional and cosmetic deficit on donor site.

Reconstruction of soft tissue defects using free serratus anterior muscle and adifofascial flap

The optimal reconstruction of soft tissue defects with exposure of blood vessel, nerve, tendon muscle, and bone requires muscle flap that provides a durable surface, appropriate bulk and stability. The serratus anterior muscle has been suggested as a versatile and reliable flap for reconstruction of head and neck and extremity injuries. In our department, reconstructive operations were performed for 18 patients who had soft tissue defect of upper or lower extremities or head from March 1995 to February 1996. We performed free flap of serratus anterior muscle in 13 patients, free flap of adipofascial tissue overlying serratus anterior muscle in 3 patients, free flap of both serratus anterior muscle and adipofascial tissue in 1 patient, free flap of serratus anterior muscle and rib in 1 patient. Their ages were 5 to 56 years, the ratio of male to female was 14 : 4. The defects involved the upper extremity in 6 patients, lower extremity in 10 patients, and scalp in 2 patients. Free flap using adipofascia overlying serratus anterior muscle was performed when gliding surface was required due to the exposure of some structure such as tendon. The average duration from operation to follow-up examination was 4 months(from 1 to 12 months). One total necrosis was observed in the patient who had crushing injury of forearm, and one partial necrosis was observed in other patient. In the rest 16 cases, results of operation were satisfactory. This kind of flap was very useful in reconstruction of soft tissue defect and gliding surface due to easy dissection, capability of getting long vascular pedicle, and no serious functional and cosmetic deficit on donor site.