Scapular Free Flap

Abstract

This 15-year-old girl was referred to us with a history of previously diagnosed ulcerative colitis and weight loss. She had been on sulfasalazine and prednisone, and at the time we were consulted she was admitted with multifocal osteomyelitis of the left leg associated with open wounds. The ulcerative colitis had been diagnosed 2 years prior to admission and had been quiescent for approximately 1 year. There were two foci of osteomyelitis diagnosed on bone scan with positive cultures for Staphylococcus. These were located in the proximal medial tibia and the lateral malleolus. Debridement of these two wounds was performed by the orthopedic service, and the patient was presented to us with open wounds involving exposed bone and history of osteomyelitis (Figure 13.1).