Background: Scapula flaps for mandible reconstruction may be an alternative if fibula free vascularized flap cannot be used, but its long term feasibility is still at debate. Purpose of this study was to evaluate the longer term functional success of the scapula flap in this limited cohort.

Materials and methods: Identification of patients receiving a scapula flap for mandible reconstruction in the period from 01/2009 to 12/2012 years was performed. Evaluation of the aesthetic and functional results postoperatively as well as the possibility of implantation in the mandible was accessed in all patients.

Results: 10 patients receiving a scapula flap for reconstruction of the mandible were identified. No flap loss was recorded. Two patients experienced wound healing problems. In one patient, due to venous stasis, a bone segment (tip) of the inserted scapula had to be removed. Successful implant placement was possible in 6/10 patients. One patient refused the insertion of dental implants, two patients suffered a tumour progression and hence did not receive implantation; one patient died during follow up.

Conclusion: Implant insertion after mandible reconstruction with scapula flap is possible – however, scapula flap should still not be considered as the free flap of choice for mandibular reconstruction.