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A Resection of the Giant First Left Rib Tumor and Chest Wall Reconstruction by Transmanubrial osteomuscular Sparing Approach

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Open Journal of Thoracic Surgery 2015年第3期5卷 35-42页

作者： Takanori Ayabe Masaki Tomita Hiroki Mori Eiichi Chosa Kunihide Nakamura Division of Thoracic and Breast Surgery Department of Surgery Faculty of Medicine University of Miyazaki Miyazaki Japan

A 64-year-old female had noticed an 11 × 6 cm mass growing on her left first rib. We performed a resection of the first and second ribs and a reconstruction of the chest wall. A thoracotomy was performed at the anterolateral second intercostal space. The second rib cartilage was divided at the left parasternum. Based on a transmanubrial osteomuscular sparing approach, the left-upper part of the sternum and the first rib cartilage were both cut at the left clavicular-sternum joint. The posterior parts of the two ribs involving the tumor were resected at the transverse process of the vertebral bone by tearing off the anterior, middle, and posterior scalene muscles, subclavicular artery and vein. The defect size of the thorax was 15 × 9 cm, which was reconstructed by covering with a polytetrafluoroethylene dual mesh (Dual mesh, Gore tex, 2 mm). The major pectoral muscle flap was used to cover the mesh. The postoperative pathological examination diagnosed a poorly differentiated fibrosarcoma. Eventually, she had palliative therapy for the postoperative metastatic chest wall. She died 14 months after the operation.

关键词： Surgery Transmanubrial osteomuscular Sparing Approach Fibrosarcoma The First Rib Tumor Chest Wall Reconstruction

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Contralateral trapezius transfer to treat scapular winging: A case report and review of literature

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World Journal of Orthopedics 2019年第1期10卷 33-44页

作者： Juan José Gil-álvarez Pablo García-Parra Manuel Anaya-Rojas María del Pilar Martínez-Fuentes Department of Orthopedics and Traumatology Hospital Universitario Virgen del Rocío Department of Rehabilitation Hospital Universitario Virgen del Rocío

BACKGROUND No dynamic technique, such as tendon transfer, has been described for scapular winging due to levator scapulae or rhomboid major and minor palsies resulting from an isolated dorsal scapular nerve injury. Thus, we evaluated how the contralateral trapezius compound osteomuscular flap transfer would work in stabilizing lateral scapular winging, and the case is reported here. A literature review was also conducted, and articles relevant to the case are *** SUMMARY A 37-year-old male patient who had sustained an isolated dorsal scapular nerve injury underwent reconstructive surgery using the contralateral trapezius compound osteomuscular flap transfer technique to treat scapular winging and the consequent pain, and to restore function from the shoulder impairment. As a result, the involved shoulder showed an improved Constant-Murley score, from19.5% to 81.88%.CONCLUSION Contralateral trapezius osteomuscular flap transfer succeeded in stabilizing scapular winging in this case, improving shoulder function and affording pain relief.

关键词： Trapezoid muscle osteomuscular flap Scapular winging Rhomboid muscles Nerve paralysis Dorsal scapular nerve Case report

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