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Rotation of the Clavicular Portion of the Pectoralis Major for Soft-Tissue Coverage of the Clavicle by G. R. Williams, K. Koffler, M. Pepe, K. Wong, B.

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Presentation on theme: "Rotation of the Clavicular Portion of the Pectoralis Major for Soft-Tissue Coverage of the Clavicle by G. R. Williams, K. Koffler, M. Pepe, K. Wong, B."— Presentation transcript:

1 Rotation of the Clavicular Portion of the Pectoralis Major for Soft-Tissue Coverage of the Clavicle by G. R. Williams, K. Koffler, M. Pepe, K. Wong, B. Chang, and d. M. Ramsey J Bone Joint Surg Am Volume 82(12):1736-1736 December 1, 2000 ©2000 by The Journal of Bone and Joint Surgery, Inc.

2 Cadaveric anatomical dissection showing the rotated flap (arrows), with the origin intact, prior to division of the acromial branch of the thoracoacromial trunk. G. R. Williams et al. J Bone Joint Surg Am 2000;82:1736 ©2000 by The Journal of Bone and Joint Surgery, Inc.

3 Radiograph showing a midshaft clavicular nonunion with atrophic medial and lateral fragments. G. R. Williams et al. J Bone Joint Surg Am 2000;82:1736 ©2000 by The Journal of Bone and Joint Surgery, Inc.

4 Figs. 3-A, 3-B, and 3-C: Illustrations showing the surgical technique for use of a rotational pectoralis major flap.Fig. 3-A: The interval between the sternocostal and clavicular heads is identified and dissected distally and laterally. G. R. Williams et al. J Bone Joint Surg Am 2000;82:1736 ©2000 by The Journal of Bone and Joint Surgery, Inc.

5 A separate skin incision is made over the humeral insertion, and the tendon of the clavicular head is identified and incised. G. R. Williams et al. J Bone Joint Surg Am 2000;82:1736 ©2000 by The Journal of Bone and Joint Surgery, Inc.

6 The vascular pedicle becomes more superficial with rotation of the flap. G. R. Williams et al. J Bone Joint Surg Am 2000;82:1736 ©2000 by The Journal of Bone and Joint Surgery, Inc.

7 Clinical photograph showing the healed clavicular incision and the contouring flap. G. R. Williams et al. J Bone Joint Surg Am 2000;82:1736 ©2000 by The Journal of Bone and Joint Surgery, Inc.

8 Radiograph made twenty-one months postoperatively, showing a healed nonunion of the clavicle. G. R. Williams et al. J Bone Joint Surg Am 2000;82:1736 ©2000 by The Journal of Bone and Joint Surgery, Inc.


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