Zhang Yixin, Qian Yunliang, Wang Danru
Department of Plastic and Reconstructive Surgery, Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006 Sep;20(9):890-2.
To discuss the reconstruction of severe neck contracture by transplanting combined scapular/parascapular bilobar flaps, and the probability to reestablish three-dimensional movement of the neck.
From January 2003 to November 2004, 9 cases of sustained severe neck contractures were treated (aged 9-32 years). The combined scapular/parascapular bilobar flaps, pedicled on the circumflex scapular vascular bundle, were microsurgically used to cover the soft tissue defect after excision of hypertrophic scar and release of contracture. The maximum size of the combined bilobar flap was 20 cm x 8 cm to 20 cm x 11 cm, while the minimum one was 15 cm x 4 cm to 15 cm x 6 cm.
The combined scapular/parascapular flaps were successfully used to treat 9 cases of severe neck contracture. All patients were satisfied with the final functional and aesthetic results. There was no recurrence during 3-9 months follow-up for 8 patients. The cervicomental angle was 90-105 degrees.
The combined bilobar scapular/parascapular flap, providing a large area of tissue for coverage in three dimensions with a reliable blood supply by only one pedicle anastomosis during operation, is a good option for reconstruction of the severe neck contracture.
探讨采用肩胛/肩胛旁双叶皮瓣移植修复重度颈部挛缩，并重建颈部三维活动度的可能性。
2003年1月至2004年11月，治疗9例持续性重度颈部挛缩患者（年龄9 - 32岁）。以旋肩胛血管束为蒂的肩胛/肩胛旁双叶皮瓣，经显微外科手术用于覆盖切除肥厚瘢痕及松解挛缩后的软组织缺损。双叶皮瓣最大尺寸为20 cm×8 cm至20 cm×11 cm，最小尺寸为15 cm×4 cm至15 cm×6 cm。
肩胛/肩胛旁双叶皮瓣成功用于治疗9例重度颈部挛缩。所有患者对最终的功能和美学效果均满意。8例患者随访3 - 9个月无复发。颈颌角为90 - 105度。
肩胛/肩胛旁双叶皮瓣可为三维覆盖提供大面积组织，术中仅需一次蒂部吻合即可保证可靠血供，是修复重度颈部挛缩的良好选择。
