Surgical technique: a novel pedicled periosteal scapular flap to facilitate bone growth in an ovine model

Background: Vascularised periosteum can used for reconstructing bony defects due to its intrinsic osteogenic properties. This osteogenic potential can be harnessed as a vascularised flap to induce bone growth of complex constructs in-vivo. The authors aimed to use a novel pedicled periosteal flap from the scapula to induce bone growth in a critical sized construct.

Methods: Eight sheep were used as live animal models. A novel periosteal flap was raised from the infraspinous fossa of each animal and wrapped around non-vascularised autologous bone graft. The constructs were allowed to incubate between 1 and 84 days before harvest. Analysis of the flap was done via histopathology using haematoxylin and eosin staining.

Results: All flaps were viable at the conclusion of surgery. Seven flaps showed variable thickening with matrix deposition. One flap was devitalised at time of harvest.

Conclusion: The novel periosteal scapular flap described is a promising technique to induce bone growth in complex constructs.