Sahasrabudhe P, Panse N, Baheti B, Jadhav A, Joshi N, Chandanwale A
Department of Plastic Surgery, B. J. Medical College and Sassoon Hospitals, Pune, Maharashtra, India.
Department of Plastic Surgery, B. J. Medical College and Sassoon Hospitals, Pune, Maharashtra, India.
J Plast Reconstr Aesthet Surg. 2015 Jan;68(1):35-9. doi: 10.1016/j.bjps.2014.09.034. Epub 2014 Sep 28.
The aim of this study was to report our experience of using distally based spilt vastus lateralis musculocutaneous flaps for soft-tissue defects around the knee joint - a new technique.
Cadaver dissection studies were conducted in three cadavers to demonstrate perforators entering the lower third of the vastus lateralis muscle arising from the superior lateral genicular artery. Its application in eight clinical cases for the reconstruction of soft-tissue defects around the knee joint is reported.
Seven out of eight flaps survived well without any flap loss. One flap with a skin island measuring 12 × 20 cm suffered a loss of 2 cm distally. This was later treated with skin grafting. Six out of eight donor sites were closed primarily. Six patients achieved full functional range of motion by 3 months. One patient had a 10° limitation of knee extension. One patient had foot drop due to primary injury and walks with a limping gait.
This flap is a new reconstructive option for knee defects. It can reach distally up to the tibial tuberosity and does not require an intraoperative change of position. The donor site can be closed primarily and is hidden inside the clothing. The function of the knee is not affected as the majority of the muscle is kept in continuity.
本研究旨在报告我们使用远端蒂股外侧肌劈开肌皮瓣修复膝关节周围软组织缺损的经验——一种新技术。
对三具尸体进行尸体解剖研究，以证明穿支血管进入起自膝上外侧动脉的股外侧肌下三分之一处。报告了其在八例膝关节周围软组织缺损重建临床病例中的应用。
八例皮瓣中有七例存活良好，无皮瓣丢失。一块带有面积为12×20厘米皮岛的皮瓣远端有2厘米的坏死，随后进行了植皮治疗。八个供区中有六个一期缝合。八名患者中有六名在3个月时膝关节活动范围恢复正常。一名患者膝关节伸展受限10°。一名患者因原发损伤导致足下垂，行走时有跛行步态。
该皮瓣是膝关节缺损的一种新的重建选择。它可以向远端延伸至胫骨结节，且术中无需改变体位。供区可一期缝合，且隐藏在衣物内。由于大部分肌肉保持连续，膝关节功能不受影响。
