Twelve patients ( 9 males and 3 females, aged between 37 and 74 years ) underwent osteocutaneous free flap harvesting between April 2008 and December 2013. Reconstruction was performed for bone defects that resulted from tumor resection or osteonecrosis of the mandible. We investigated the functional outcome of the donor site. Scapular body fractures were detected in 4 patients. In these patients, the mean ratio of the length of the harvested bone graft to that of the scapular lateral wedge was 77 %, which was significantly greater than that in the patients without postoperative scapular fracture ( 62 % ). We considered that there would be a risk of postoperative scapular body fracture as a risk in the donor site after harvesting a scapular bone graft, especially when the graft length is over 70 % of the lateral scapular wedge. The shoulder function of the donor site was satisfactory at one year after surgery in all of the patients with or without a scapula fracture.
