Version June 2024
| Flap name | Vascular supply | Pedicle length | Flap characteristics | Common uses | Advantages |
| Fibula | Peroneal artery | Up to 15 cm (dependent on amount of bone utilized) | Outstanding bone stock for mandible and maxilla reconstruction, may be osteotomized, may receive osseointegrated implants. | Mandible and maxilla reconstruction | Long segment of fibula may be harvested, which is advantageous in large mandible defects where osseocutaneous radial forearm and scapula donor sites may not provide enough length. |
| Scapular tip | Angular branch of thoracodorsal artery | 8 to 13 cm | Flat piece of bone covered in muscle, may be osteotomized but often contoured into the shape of the defect. Bone harvested can be up to 9 cm. May be harvested as a chimeric flap with the latissimus dorsi paddle and/or serratus anterior. | Mandible and maxilla reconstruction | Does not require skin graft for closure and avoids a donor site in the lower extremity. Available in patients with peripheral arterial disease who lack three-vessel vascular supply to the foot. Scapular tip flap provides a longer pedicle and more convenient positioning and flap harvest compared with lateral border scapula. |
| Lateral border scapula | Circumflex scapular artery | 3 to 7 cm | May provide up to 10 to 14 cm of bone. May be harvested with a fasciocutaneous parascapular skin paddle as well as the latissimus dorsi flap. | Mandible and maxilla reconstruction | Does not require skin graft for closure and avoids a donor site in the lower extremity. Available in patients with peripheral arterial disease who lack three-vessel vascular supply to the foot. Provides longer segment of bone than the scapular tip flap. |
| Osseocutaneous radial forearm | Radial artery | 14 to 21 cm | Thin segment of bone, approximately 40% of the thickness of the radius. May be osteotomized. Often harvested with fasciocutaneous skin paddle. | Mandible and maxilla reconstruction | Available in patients with peripheral arterial disease who lack three-vessel vascular supply to the foot. Thin segment of bone is ideal for posterior mandibular defects and inferior orbital rim defects. Long pedicle. |
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