Landen S, Delefortrie G, Rossillon D, Sesma G
Service de Chirurgie Orthopédique et Traumatologique, Hôpital de Jolimont, Haine Saint Paul, Belgique.
Ann Chir Plast Esthet. 1992 Jun;37(3):333-7.
The authors describe a musculocutaneous flap which can be used in trochanteric pressure sores in paraplegics. Described by Little and Lyons (1983), this reconstructive unit combines the proximal muscular segment of the tensor fasciae latae (TFL) and gluteus medius muscles in a round shaped flap pedicled on the lateral circumflex femoral artery. The anatomical basis of this muscle combination is found in the anastomotic network between the superior gluteal artery which supplies gluteus medius muscle and lateral circumflex femoral artery, the principal vascular pedicle of the TFL muscle. Cutaneous defects of the trochanter and associated osteitis are frequent complications in paraplegic patients which often require ostectomy and coverage of the bony prominence by well vascularised, padded skin. Musculocutaneous flaps are well suited for this purpose and we review various reconstructive units that may be brought into trochanteric defects. Among these, the gluteus medius-TFL flap appears to be an interesting option for, in case of recurrent ulcers, other donor areas are left intact, and the flap itself could give rise to a subsequent "traditional" TFL flap.
作者描述了一种可用于截瘫患者转子部压疮的肌皮瓣。由利特尔和莱昂斯（1983年）描述，这个重建单元将阔筋膜张肌（TFL）的近端肌肉段和臀中肌组合成一个以旋股外侧动脉为蒂的圆形皮瓣。这种肌肉组合的解剖学基础在于供应臀中肌的臀上动脉与阔筋膜张肌的主要血管蒂旋股外侧动脉之间的吻合网络。转子部皮肤缺损和相关骨炎是截瘫患者常见的并发症，常常需要进行骨切除术并用血运丰富、有衬垫的皮肤覆盖骨突。肌皮瓣非常适合此目的，我们回顾了可用于转子部缺损的各种重建单元。其中，臀中肌-阔筋膜张肌皮瓣似乎是一个有趣的选择，因为在复发性溃疡的情况下，其他供区保持完好，并且该皮瓣本身可形成后续的“传统”阔筋膜张肌皮瓣。
