Miyamoto Shimpei, Fujiki Masahide, Nakatani Fumihiko, Sakisaka Masanobu, Sakuraba Minoru
Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
Division of Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan.
Microsurgery. 2015 Sep;35(6):485-8. doi: 10.1002/micr.22421. Epub 2015 Apr 25.
Reconstruction of complex knee defects including the popliteal artery presents a challenging problem in reconstructive microsurgery. Reconstruction of the popliteal artery and soft-tissue coverage should be performed simultaneously for limb salvage. We present the one-stage reconstruction of a complex knee defect including the popliteal artery using a free flow-through anterolateral thigh (ALT) flap as a bypass flap in two patients with sarcomas. In both patients, the popliteal artery and vein were reconstructed using branches of the lateral circumflex femoral arterial system. The flaps survived without vascular compromise and the limbs were preserved successfully. Free flow-through ALT flap enables simultaneous leg revascularization and soft-tissue coverage with a single free flap. The lateral circumflex femoral arterial system has many branches with large diameters, making it suitable for reconstruction of multiple infrapopliteal arteries.
包括腘动脉在内的复杂膝关节缺损的重建是重建显微外科中一个具有挑战性的问题。为挽救肢体，应同时进行腘动脉重建和软组织覆盖。我们介绍了在两名肉瘤患者中，使用游离穿支股前外侧（ALT）皮瓣作为搭桥皮瓣对包括腘动脉在内的复杂膝关节缺损进行一期重建的情况。在这两名患者中，均使用旋股外侧动脉系统的分支重建了腘动脉和静脉。皮瓣存活且未出现血管并发症，成功保住了肢体。游离穿支ALT皮瓣能够通过单个游离皮瓣同时实现小腿血运重建和软组织覆盖。旋股外侧动脉系统有许多大直径分支，适合用于多条腘动脉以下动脉的重建。
