[Reconstruction of lower limb involving free serratus anterior with rib myo-osseous composite flap: 20 patients followed for 5 years]. / Le lambeau libre composite costomusculaire de serratus anterior dans le traitement des pertes de substance complexes du membre inférieur : à propos de 20 cas avec 5 ans de recul.

INTRODUCTION: In our team, free flap and especially serratus anterior muscle is the first option for the coverage of lower limb post-traumatic defects. For complex tissue loss, it may be advantageous to harvest the free serratus anterior with rib myo-osseous composite flap. We performed 20 osteomuscular serratus anterior composite flap between 2008 and 2010. MATERIALS AND METHODS: We retrospectively studied the records of 20 patients, by separately analyzing the characteristics of the bone defect and the soft tissue loss. Patients have been recently reviewed by an independent operator. We compared our results to other reconstruction techniques and other similar series reported in the literature. RESULTS: The average age of our patients was 43 years and 11 months. In all cases, defect was traumatic. The average follow-up was 5 years (4.5 to 5.8). The average flap area was 135cm(2) and the average rib length was 9.21cm. Our microsurgical success rate is 95%. Our global consolidation rate is 82%. DISCUSSION: Use of vascularized rib in the treatment of lower limb traumatic defects is rare. The bone quality of rib is lower than fibula, but the coverage provided is better, due to serratus anterior muscle. The length and diameter of the vascular pedicle is very useful too. Our results are comparable to other series using this flap. Its coverage properties and the possibility of simultaneous bone reconstruction is useful. It allows one stage procedure for complex tissue losses with satisfactory results in the short and long term. The further realization of a free fibular transfer in cases of persistent non union remains possible.

[Scalp flap pedicled on the posterior auricular artery. Anatomical study and clinical application]. / Lambeau de scalp pédiculé sur l'artère auriculaire postérieure. Étude anatomique et application clinique.

INTRODUCTION: Management of scalps defect is a common subject for reconstructive surgery. The use of local flap is better because of the hairy skin. OBJECTIVE: The auricular posterior artery is often described as an accessory blood supply for the scalp. METHOD: We present an original case of 16×6 cm scalp flap harvested almost in "vascular island" on the right retro-auricular pedicle to cover an occipital wound. RESULTS: We have obtained an effective healing in 20 days. Despite its considerable length, no distal necrosis has occurred. CONCLUSION: Rarely reported in the surgical literature, the posterior auricular vessels are a good blood supply to harvest scalp flap. This procedure adds to overall techniques of reconstructive surgery for scalps defects that plastic surgeons can use.

[A rare congenital lesion: bronchogenic cyst. Case report and review of the literature]. / Une lésion congénitale rare : le kyste bronchogénique. À propos d'un cas clinique et revue de la littérature.

Cutaneous bronchogenic cysts are very rare congenital lesions. Scapular localization is frequently found in the literature. Only the histological analysis can confirm the diagnosis, because no clinical characteristic is pathognomonic. Surgical excision of the lesion is justified by the risk of local infection and discomfort related to the recurrent flow.