Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al. |
B. Both anterior and posterior skin flaps are elevated with this technique. After the flap template is marked on the fascial surface, the edges of the flap are incised superiorly and posteriorly. The fascial flap is elevated in the loose, areolar tissue plane over the temporalis muscle and fascia. Dissection on the anterior border is undertaken carefully to preserve the frontal branch of the facial nerve, which is not always exposed or seen during the operation.
PLATE X-3 A. In the osteofascial flap, the length of pedicle between the recipient vessels (in a free flap transfer) or point of rotation (in a pedicle flap) and the bone defect determines where on the TPF the bone graft will be harvested. The mandibular defect has been defined. The cranial bone donor site is selected to allow a relaxed arc of rotation on the superficial temporal vessels.
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Clinical Cases CASE 1 A gunshot wound to the dominant hand on its ulnar aspect fractured the metacarpal neck, cut both flexor tendons and digital nerves, and devascularized the fifth digit. The injured |
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