Traumatic dislocation of the lumbar spine at two levels

Abstract

Ablation of the scapula as a result of trauma has not, to our knowledge, been described previously. The use of the pedicled latissimus dorsi myocutaneous flap in reconstructing soft tissue defects in the shoulder region is well described (Dowden and McCraw, 1980; Cohen, 1985). In our case, the latissimus dorsi flap was used to provide not only soft tissue cover, but also a muscle transfer to replace the lost deltoid muscle, thus providing antigravity action and also a small amount of active shoulder extension. This has resulted in a stable, pain-free shoulder which has descended minimally in the intervening 18 months, and has some similarities to the 'muscle sling' concept described to prevent a hanging shoulder after radical scapulectomy or the Tikhoff-Linberg procedure (Kurer et al., 1988). The use of K6ntscher nail fixation of the humerus to the second rib or to the end of the clavicle for the same purpose has also been described (Marcove et al., 1977). References