PMC8366646_01
Soft tissue defect and clavicular non-union after repeated debridements and vacuum dressings. Bone defect was filled with antibiotic beads.
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Initial debridements and vacuum-assisted closure dressings had already been performed, leaving a soft-tissue defect (Figure 1) sized approximately 25 x 5 cm, with clavicular bone exposed over a length 20 cm and with an osseous defect of 2 cm.
Interposition of a 4 cm iliac crest graft and fixation by a locking plate.
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An iliac crest graft of an adequate size was harvested, introduced into the defect and fixed with an osteosynthesis plate (Medartis locking plate, Figure 2).
Coverage of the bone graft and the locking plate by a pectoralis major flap elevated via a short scar submammary incision.
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The flap was pulled through a subcutaneous tunnel and used for coverage of the bone graft and the plate (Figure 3).
X-ray imaging 8 weeks after surgery shows good embedding of the bone graft and regular plate and screw positions.
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Post-surgical course was uneventful, with good graft embedding according to X-ray imaging 8 weeks after surgery (Figure 4) and good soft tissue healing (Figure 5).
Postoperative result after 8 weeks: good defect coverage, inconspicuous scar and only minor impairment of the chest form can be observed.
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Post-surgical course was uneventful, with good graft embedding according to X-ray imaging 8 weeks after surgery (Figure 4) and good soft tissue healing (Figure 5).