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采用股直肌游离皮瓣挽救计划中的ALT皮瓣用于小儿下肢重建:1例示范病例报告

Salvage of planned ALT flap with rectus femoris free flap for pediatric lower extremity reconstruction: A demonstrative case report.

作者信息

Gelidan Adnan G

机构信息

The Division of Plastic Surgery, King Saud University, P.O. Box 7805, Riyadh, 11462, Saudi Arabia.

出版信息

Int J Surg Case Rep. 2018;51:67-70. doi: 10.1016/j.ijscr.2018.08.005. Epub 2018 Aug 9.

Abstract

INTRODUCTION

Free tissue transfer in children represents a good option for reconstruction in skilled hands despite the technical difficulties, and represent a significant challenge in microsurgery. With Anteriorlateral thigh flap is a popular option even in pediatric age group.

PRESENTATION OF CASE

We report here a case of 9 year old girl that sustained a lower extremity trauma with exposed ankle joint secondary to Motor Vehicle Crash, That was planned for (ALT) Anterior Lateral Thigh flap reconstruction, and was not completed and salvaged by rectus femoris flap as an alternative option on table to complete the reconstruction.

DISCUSSION

Such case was successfully reconstructed by rectus femoris muscle free flap when ALT (Anterior lateral thigh) flap could not be completed as planned although it's the workhorse flap in majority of cases, due to absence of perforator utilizing the same vascular anatomical blood supply with no significant donor site morbidity.

CONCLUSION

Based on this case report the rectus femoris flap was successfully performed, and we believe it's an effective and reliable backup option to reconstruct complex lower extremity wound even in pediatric age group.

摘要

引言

尽管存在技术难题,但对于技术娴熟的医生来说,儿童游离组织移植是一种很好的重建选择,也是显微外科手术中的一项重大挑战。股前外侧皮瓣即使在儿童年龄组中也是一种常用的选择。

病例介绍

我们在此报告一例9岁女孩,因机动车碰撞导致下肢创伤,踝关节外露,计划采用股前外侧皮瓣(ALT)进行重建,但手术未完成,术中改用股直肌皮瓣作为替代方案完成重建。

讨论

尽管股前外侧皮瓣在大多数情况下是常用皮瓣,但在本病例中,由于缺乏穿支血管,无法按计划完成股前外侧皮瓣移植,最终成功采用股直肌游离皮瓣进行重建,利用相同的血管解剖血供,供区并发症不明显。

结论

基于本病例报告,股直肌皮瓣移植手术成功,我们认为即使在儿童年龄组中,它也是重建复杂下肢伤口的一种有效且可靠的备用选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebab/6108076/8a6f2516872c/gr1.jpg

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