Department of Orthopedic and Traumatology Surgery, Hôpital Ambroise Paré, Boulogne-Billancourt, France.
Department of Orthopedic and Traumatology Surgery, Hôpital Antoine Béclère, Clamart, France.
Morphologie. 2022 Jun;106(353):75-79. doi: 10.1016/j.morpho.2021.02.011. Epub 2021 Mar 19.
Soft-tissue reconstruction following acetabular or proximal femur resection for bone tumors is challenging. The vastus lateralis flap has been proposed as an advancement or rotational flap to cover soft-tissue defects for such locoregional indications. We performed an anatomical and a radiological study to assess the vascularization of the proximal vastus lateralis muscle achieved through the transverse branch of the lateral circumflex femoral artery in order to decrease the morbidity of the classical flap retrieval technique.
Five fresh adult cadavers were dissected bilaterally. Each vastus lateralis dissection was prealably injected with contrast-media agent through the lateral circumflex artery and CT scan images was recorded. A descriptive and an analytical study were carried out.
The median length and width of the entire muscle were 31.2cm (Q1-Q3: 29.7-33.3) and 12.7cm (Q1-Q3: 7.0-14.9), respectively; the median surface area of the entire vastus lateralis muscle was 282cm (Q1-Q3: 172.6-455.6) cm. The median length and width of the perfused area were 13.3cm (Q1-Q3: 12.3-16.6) and 9.4cm (Q1-Q3: 6.9-8.8) cm, respectively; the median surface of the perfused area was 89.4cm (Q1-Q3: 67.4-110.5) cm. The mean length of the pedicle measured on the CT scan was 6.3cm (95% CI: 5.5-7.1).
The proximal vastus lateralis flap as a pedicled muscular flap supplied by the transverse branch of the lateral circumflex femoral artery is a muscular flap that can be used by reconstructive and orthopaedic surgeons to repair soft-tissue defects around the hip joint without undue damage to the functional apparatus of the knee.
髋臼或股骨近端切除后进行软组织重建具有挑战性。股外侧肌皮瓣已被提议作为一种推进或旋转皮瓣，用于覆盖此类局部区域适应证的软组织缺损。我们进行了一项解剖学和影像学研究，以评估通过外侧旋股动脉横支获得的近端股外侧肌的血管化情况，以便降低经典皮瓣获取技术的发病率。
对 5 具新鲜成人尸体进行双侧解剖。对每块股外侧肌进行预先注射对比剂，通过外侧旋股动脉进行，并记录 CT 扫描图像。进行了描述性和分析性研究。
整个肌肉的平均长度和宽度分别为 31.2cm（Q1-Q3：29.7-33.3）和 12.7cm（Q1-Q3：7.0-14.9）；整个股外侧肌的平均表面积为 282cm（Q1-Q3：172.6-455.6）cm。灌注区域的平均长度和宽度分别为 13.3cm（Q1-Q3：12.3-16.6）和 9.4cm（Q1-Q3：6.9-8.8）cm；灌注区域的平均表面为 89.4cm（Q1-Q3：67.4-110.5）cm。CT 扫描上测量的蒂的平均长度为 6.3cm（95%CI：5.5-7.1）。
近端股外侧肌皮瓣作为由外侧旋股动脉横支供应的带蒂肌皮瓣，是一种可由重建和矫形外科医生使用的肌肉瓣，用于修复髋关节周围的软组织缺损，而不会对膝关节的功能装置造成不必要的损害。
