{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:01:55Z","timestamp":1753869715847,"version":"3.41.2"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Septic nonunion after vertebral fusion can lead to significant patient disability. The management of septic nonunions usually involves surgical debridement, bone fixation, and antibiotic therapy. Particularly challenging is lumbosacral vertebral nonunions, which necessitate a difficult surgical approach. We present a novel approach using a scapula tip free flap through an intra\u2010abdominal approach to reconstruct a L5\u2013S1 vertebral defect after a septic nonunion. Our patient, 31\u2010year\u2010old man, with no medical conditions, had a fusion of L5\u2013S1 due to severe lower back pain secondary to isthmic spondylolysis and spondylolisthesis. Despite multiple attempts of surgical fusion, postoperatively the patient developed a septic nonunion. Following a modified DAIR, the nonunion was reconstructed with a scapula tip bone flap 4\u2009\u00d7\u20093\u2009\u00d7\u20092\u2009cm. The subscapular vessels were anastomosed to the deep inferior epigastric vessels after an intra\u2010abdominal inset. The patient was discharged at 15\u2009days postoperatively without any complications. At 1\u2010year follow\u2010up the patient is pain\u2010free, off opiate analgesia with radiological evidence of fusion between the scapula tip, L5 and the S1 vertebral body. This case report describes the use, for the first time, of a free scapula tip, to a lumbosacral spinal defect. The use of the free scapula tip flap may be considered for reconstruction of osseous spinal defects due to its long pedicle and the unique bone shape.<\/jats:p>","DOI":"10.1002\/micr.31236","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T12:01:24Z","timestamp":1726747284000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Free Vascularized Scapula tip Flap to <scp>L5<\/scp>\u2014<scp>S1<\/scp> Vertebral Defect After Chronic Infection Related to Interbody Fusion Cage: A Case Report"],"prefix":"10.1002","volume":"44","author":[{"given":"Frank\u00a0O.\u00a0F.","family":"Reilly","sequence":"first","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital and Department of Surgical Sciences Uppsala University  Uppsala 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