ARTHRODESIS FOLLOWING TUMOR RESECTION - RECONSTRUCTION OF THE SHOULDER CONTOUR WITH THE FREE TRAM FLAP

Upper arm bone- and shoulderresection due to cancer have to be perform ed under onkologic criteria. Soft tissue however may not be sufficient to safely cover a following arthrodeses. To avoid perforation and rec onstruct a normal shouldercontour a free myocutanous TRAM-flap was emp loyed and its vessels anastomosed to branches of A. and V.brachialis. Incorporating the facia and an island of M. rectus abdominis prooved t o safely cover the arthrodetic material and shape the bulk of the flap , allowing to reconstruct the desired contour. Good vascularisation po stoperatively preserved tissue stability and volume and thus safely re stored normal shoulder contour even in a long time review.