|Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.|
| The shoulder should be immobilized in an adducted position in the immediate postoperative period. This not only protects the muscle repairs to the scapula, but also protects the skin incision from tension. Seven to ten days postoperatively, the patient should begin gentle Codman exercises. Range-of-motion exercises should progress so that a secondary adhesive capsulitis does not develop. Permanent limitation of shoulder motion has not been reported.
A. Operative position and surface markings of the osteocutaneous scapular flap. The preparation should include the entire upper extremity and start from posterior midline to anterior midline.
| C. The bone graft from the lateral border is being cut of transection of branches of the circumflex scapula to the posterior surface of the scapula.
A. The compound flap has been separated and is viewed from its deep surface, showing the vascular supply from the thoracodorsal-circumflex scapular pedicle to the bone segment and skin segment.
A 65-year-old man underwent resection of a left mandibular and floor-of-the-mouth tumor.
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