Rectus femoris myocutaneous flaps for trochanteric ulcers.

The local skin flaps traditionally used to repair trochanteric ulcers in paraplegics are usually thin, have poor padding qualities and often break down. The rectus femoris myocutaneous flap was used to repair trochanteric ulcers in eight paraplegic patients. Three flaps healed primarily. In three there was some necrosis at the distal corner of the flap but this healed spontaneously. The cutaneous portion of two flaps necrosed and had to be excised but the muscle remained viable. All eight flaps remain healed with no evidence of breakdown. The repetitive shear forces over the prominent mobile hip joint cause particular problems in providing a stable flap repair, but the rectus femoris myocutaneous flap has demonstrated, in this series, its stability and durability.