Reconstruction of Large Post-traumatic Defect over Upper Chest with Open Clavicle Fracture by Latissimus Dorsi Muscle Flap
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Abstract
Tumor resection and trauma are the most common chest wall defects that require reconstruction. All these patients need careful preoperative evaluation and good surgical techniques. The defect’s location, size and nature determine the selection of reconstruction. Water and air-tight closure of the chest cavity and adequate stability with acceptable cosmetic appearance are the reconstruction goals. Large defect over the upper chest is difficult to manage, especially in the case of an open fracture. Here we present the case of a large traumatic defect of size 20 x 15 cm over the upper chest, covering clavicular region and anterior shoulder. The patient had open clavicle fracture and Pneumothorax secondary to rib fracture for which ICD is placed. Post debridement, clavicle is fixed with External fixator and defect of upper chest is reconstructed with LD muscle flap and Skin grafting to cover the fractured segments of rib and major vascular structures.
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