Suba Santanu, Giri Sanjay Kumar, Pant Priyanka, Kanungo Aparna
From the Department of Plastic and Reconstructive Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Ann Plast Surg. 2022 Jun 1;88(6):647-657. doi: 10.1097/SAP.0000000000003057. Epub 2022 Apr 3.
Soft tissue defects with exposed tendon, bones, and joints around the knee are difficult and challenging to treat because of its location over a joint, requires a stable cover that is supple and stretchable. For any knee defects, the gastrocnemius muscle flap is the first choice for the reconstruction, although it causes less functional deficit; however, because of its less reach, it is difficult to cover the defect in the superolateral aspect of knee joint and anterior to the tibial tuberosity with the other disadvantage being the bulkiness. The medial sural artery perforator flap (MSAPF) provides thin fasciocutaneous tissue similar to the adjacent normal soft tissue in the knee and so, its use leads to an improved reconstruction of contour and eliminating the need of a skin graft over the primary defect. Here, we will be discussing a case series using MSAPF to cover the defects around the knee.
膝关节周围伴有肌腱、骨骼和关节外露的软组织缺损因其位于关节上方，治疗困难且具有挑战性，需要一个柔软且可拉伸的稳定覆盖物。对于任何膝关节缺损，腓肠肌肌瓣是重建的首选，尽管它造成的功能缺陷较小；然而，由于其覆盖范围有限，难以覆盖膝关节外上侧和胫骨结节前方的缺损，另一个缺点是体积较大。腓肠内侧动脉穿支皮瓣（MSAPF）提供了与膝关节相邻正常软组织相似的薄筋膜皮肤组织，因此，使用该皮瓣可改善外形重建，并消除在原发性缺损上植皮的必要性。在此，我们将讨论一组使用MSAPF覆盖膝关节周围缺损的病例。
