This study is based on anatomical observation and measurement of sternocleidomastoid muscle and masseterie region on 50 cadavers (totally 100 sides). It provides reliable data for clinical design and empoyment of the sternal end of the sternocleidomastoid muscle for the myocutaneous flap repair of musculoeutaneous defects in the masseterie region following firearm wounds. There has been no flap failure except minimal donor site complications in 6 patients undergoing these reconstructions. Advantages of the use of myoeutaneous flap over prevoius reconstructive methods are the availablity of dual blood supples and preservation of both motor and sensory nerve innervatoins. The successful results following these reconstructive operations showed much better restoration of mastieatory function and far earlier recovery of skin sensation.

To find a new way of reconstruction of mandibular defects, transplantation of vascularized rib graft, small-sized iliac bone flap, large-sized iliac bone flap, and fibula flap were used to reconstruct mandibular defects. Among 76 cases of mandibular defects repaired with these bone grafts, 69 grafts survived completely(the survival ratio was 92%). Compared with traditional autogenous bone transplantation, vascularized autogenou bone grafting showed a series of advantages, such as rich blood supply of bone flap, stronger anti-infection property, higher survival rate and so on.

Objective The purpose of this study was to improve the clinical results of the treatment firearm injury to maxillofacial-cervical region, so as to raise the life quality of these patients. Methods Based on the study of the anatomical study of this region, different methods were adopted to reconstruct various maxillofacial-cervial firearms injuries. Three methods were adopted to reconstruct the mandibular region by early bone transplantation to the defects of the mandible in diffferent regions. In patients with combined defects of the mandible and soft tissue, the defects were repaired by transplantation of vascular pedicle graft with muscle and nerve or free tissue transplantation to restore function. Results The survival-rate of early bone transplantation was 91.52%(54/59). The rate of function restoration was 90.72%(88/97) in cases of tissue flap grafting. Conclusions Applied anatomy is the basic of design new surgery method. Tne new developed surgery methods can improve clinical cured effect of maxillofacial-neck region firearms injure.