Shouldering the load of mandible reconstruction: 81 cases of oromandibular reconstruction with the scapular tip free flap

BACKGROUND: The scapular tip free flap (STFF) is becoming more popular for oromandibular reconstruction. This article reviewed the early and late outcomes in a larger series over 9 years. METHODS: We conducted a retrospective review of all consecutive patients who underwent oromandibular reconstruction using the STFF at London Health Sciences Centre. Demographic information, surgical data, and complications were collected and analyzed. RESULTS: From April 2008 to March 2017, 81 STFFs were performed in 80 patients. The average bony reconstruction measured 5.4 cm. Bone-only flaps were utilized in 24 cases (29.6%). Five cases (6.2%) required a single osteotomy. There were 3 (3.7%) flap failures. There were 7 plate extrusions and 11 cases of radiographic nonunion. CONCLUSION: The STFF is a reliable option with acceptable early and long-term results. The STFF may be considered as a first line option especially for shorter bone defects or in conjunction with complex soft tissue requirements.