Aix-Marseille université, 13284 Marseille, France; Service de chirurgie plastique et réparatrice, AP-HM, hôpital Conception, 13005 Marseille, France.
Aix-Marseille université, 13284 Marseille, France; Service de chirurgie orthopédique, AP-HM, hôpital Nord, 13915 Marseille, France.
Orthop Traumatol Surg Res. 2018 Sep;104(5):713-717. doi: 10.1016/j.otsr.2018.05.006. Epub 2018 Jun 19.
Infection is a common complication of major lower limb-sparing surgery with massive total knee prosthesis (MTKP) reconstruction after extensive tumour resection. When free tissue transfer is required to cover the prosthesis, musculo-cutaneous flaps are usually preferred based on proven efficacy when used in both one-stage and two-stage procedures. The use of a free fascio-cutaneous antero-lateral thigh (FC-ALT) flap in 3 patients with infected knee reconstructions is reported here.
A retrospective study was performed of 3 patients in whom a free FC-ALT flap was used during a two-stage procedure to treat MTKP infection after femoral sarcoma resection.
Free FC-ALT flap transfer and exchange arthroplasty were successful in all 3 patients. Two years after the procedure, no patient had required amputation or experienced recurrent infection.
A free FC-ALT flap can provide adequate coverage of infected MTKP and deserves to be viewed as a valid alternative to free muscle flaps.
在广泛的肿瘤切除后，采用大量全膝关节假体（MTKP）重建进行主要下肢保肢手术时，感染是一种常见的并发症。当需要游离组织移植来覆盖假体时，通常基于在一期和二期手术中使用时的已证实疗效而首选肌皮瓣。本文报告了 3 例感染性膝关节重建中使用游离前外侧股部筋膜皮瓣（FC-ALT）的情况。
对 3 例在股骨肉瘤切除后，采用游离 FC-ALT 皮瓣进行二期手术治疗 MTKP 感染的患者进行回顾性研究。
游离 FC-ALT 皮瓣转移和关节置换术在所有 3 例患者中均成功。术后 2 年，无患者需要截肢或出现感染复发。
游离 FC-ALT 皮瓣可提供对感染 MTKP 的充分覆盖，值得被视为游离肌肉瓣的有效替代方案。
