Extended rotation-transposition of the pectoralis major myocutaneous flap in the repair of lesions over the shoulder.

An extensive area of radionecrosis over the shoulder was treated by side excision and closed with a pectoralis major myocutaneous flap. To reach the surgical defect the vascular pedicle of the flap had to be rotated 180 degrees. No complications were encountered. This result illustrates another application of the use of this flap. It may be prudent to leave a good deal of muscle around the vascular pedicle in those manoeuvres which require large angles of rotation.