Journals / Turkish Journal of Plastic Surgery / 2017 / Cilt: 25 - Sayı: 4

Chimeric Gastrocnemius-Medial Sural Artery Perforator Fasciocutaneous Propeller Flap for the Reconstruction of Wide 1/3 Proximal Leg Defects

Bacak 1/3 Proksimali Geniş Defektlerinde Kimerik Gastroknemius-Medial Sural Arter Perforatör Fasyokütan Pervane Flep Kullanımı

Pages
173–177
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In this article we want to describe our experiences of chimeric flap elevating by adding the medial sural artery perforator fasciocutaneous propeller flap to the muscle flap for the reconstruction of the knee region, especially the lateral side where gastrocnemius muscle flap cover is insufficient.Material and Methods: We used chimeric gastrocnemius-medial sural artery perforator propellar flap for reconstruction in 2 patients with a wide defect in 1/3 leg proximal.Results: There were no postop complications and the reconstruction procedure achieved acceptable aesthetic and functional outcomesConclusion: The chimeric medial gastrocnemius muscle and sural artery perforator fasciocutaneous propellar flap can be used effectively in the wide defects of the knee region, because it minimizes donor site morbidity, encloses the knee lateral and the patellar area, and does not necessitate microsurgery

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The gastrocnemius muscle flap is the most commonly used reconstruction option for the defects of the upper third lower limb.
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Key Findings & Data:This flap has an important role in filling the dead space or dealing with osteomyelitis, if present.
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Conclusion & Impact:In this article we want to describe our experiences of chimeric flap elevating by adding the medial sural artery perforator fasciocutaneous propeller flap to the muscle flap for the reconstruction of the knee region, especially the lateral side where gastrocnemius muscle flap cover is insufficient.Material and Methods: We used chimeric gastrocnemius-medial sural artery perforator propellar flap for reconstruction in 2 patients with a wide defect in 1/3 leg proximal.Results: There were no postop complications and the reconstruction procedure achieved acceptable aesthetic and functional outcomesConclusion: The chimeric medial gastrocnemius muscle and sural artery perforator fasciocutaneous propellar flap can be used effectively in the wide defects of the knee region, because it minimizes donor site morbidity, encloses the knee lateral and the patellar area, and does not necessitate microsurgery
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: The gastrocnemius muscle flap is the most commonly used reconstruction option for the defects of the upper third lower limb. This flap has an important role in filling the dead space or dealing with osteomyelitis, if present. However, the arc of rotation renders the flap inadequate for both the lateral and superior knee joint and the patellar region. Therefore, in cases with large defects around the knee, there are various methods to improve the extended gastrocnemius muscle flap. These methods can extend the surgery period and jeopardize flap viability. In this article we want to describe our experiences of chimeric flap elevating by adding the medial sural artery perforator fasciocutaneous propeller flap to the muscle flap for the reconstruction of the knee region, especially the lateral side where gastrocnemius muscle flap cover is insufficient.Material and Methods: We used chimeric gastrocnemius-medial sural artery perforator propellar flap for reconstruction in 2 patients with a wide defect in 1/3 leg proximal.Results: There were no postop complications and the reconstruction procedure achieved acceptable aesthetic and functional outcomesConclusion: The chimeric medial gastrocnemius muscle and sural artery perforator fasciocutaneous propellar flap can be used effectively in the wide defects of the knee region, because it minimizes donor site morbidity, encloses the knee lateral and the patellar area, and does not necessitate microsurgery

Özet

Amaç: Bacak 1/3 proksimali defektlerinin rekonstrüksiyonunda en sık kullanılan yöntem gastroknemius kas flebidir. Bu flep ölü boşluğu doldurmada, var ise osteomiyelit ile başa çıkmada önemli bir role sahiptir, fakat rotasyon arkı nedeniyle diz laterali, superioru ve patellar bölge rekonstrüksiyonu için sıklıkla yetersiz kalmaktadır. Bu nedenle diz çevresinin geniş defektlerinde gastroknemius kas flebinin rotasyon arkını artırmak için çeşitli yöntemler kullanılmaktadır. Bu yöntemler cerrahi süresini uzatmakta, flep yaşayabilirliliğini tehlikeye sokmaktadır. Bu makalede diz çevresinin, özellikle gastroknemius kasının kapatmakta yetersiz kaldığı lateral kısmının rekonstrüksiyonu için kas flebine medial sural arter bazlı perforatör fasyokütan pervane flep eklenerek planlanan kimerik flep deneyimlerimizi anlatmak istedik.Gereç ve Yöntemler: Bacak 1/3 proksimalinde geniş defekti olan 2 hastada rekonstrüksiyon için kimerik gastroknemius-medial sural arter perforatör fasyokütan pervane flep kullandık.Bulgular: Ameliyat sonrası dönemde herhangi bir komplikasyon ile karşılaşılmadı. Estetik ve fonksiyonel olarak kabul edilebilir sonuçlar aldık. Sonuç: Medial gastroknemius-medial sural arter perforatör fasyokütan kimerik flebi minimal donör saha morbiditesi, diz laterali ve patellar bölgenin kapatılabilmesi, mikrocerrahi gerektirmemesi nedeniyle diz bölgesinin geniş defektlerinde alternatif yöntem olarak kullanılabilir

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Cite This Article

DEMİR, C. İ., YAŞAR, E. K., UZUN, C., GÖK, A., DAVUN, K., ALAGÖZ, M. Ş. (2017). Chimeric Gastrocnemius-Medial Sural Artery Perforator Fasciocutaneous Propeller Flap for the Reconstruction of Wide 1/3 Proximal Leg Defects. Turkish Journal of Plastic Surgery, Cilt: 25 - Sayı: 4, 173–177. https://ajindex.com/articles/375878

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References (1)

  1. Innocenti M, Cardin-Langlois E, Menichini G, Baldrighi C. Gastrocnaemius-propeller extended miocutanous flap: a new chimaeric flap for soft tissue reconstruction of the knee. J Plast Reconstr Aesthet Surg 2014; 67(2): 244-51. [CrossRef] 2. Covall DJ, Fowble CD, Foster TE, Whitelaw GP. Bicondylar tibial plateau fractures: principles of treatment. Contemp Orthop 1994; 28(2): 115-22. 3. Spagnolo R, Pace F. Management of the Schatzker VI fractures with lateral locked screw plating. Musculoskelet Surg 2012; 96(2): 75-80. [CrossRef] 4. Phisitkul P, McKinley TO, Nepola JV, Marsh JL. Complications of locking plate fixation in complex proximal tibial injuries. J Orthop Trauma 2007; 21(2): 83-91. [CrossRef] 5. Singer S, Eberlein TJ. Surgical management of soft-tissue sarcoma. Adv Surg.1997; 31: 395-420. 6. Singer S, Demetri GD, Baldini EH, Fletcher CD. Management of soft-tissue sarcomas: an overview and update. Lancet Oncol 2000; 1: 75-85. [CrossRef] 7. Shim JS, Kim HH. A novel reconstruction technique for the knee and upper one third of lower leg. J Plast Reconstr Aesthet Surg 2006; 59(9): 919-26. [CrossRef] 8. Hallock GG. Chimeric gastrocnemius muscle and sural artery perforator local flap. Ann Plast Surg 2008; 61(3): 306-9. [CrossRef] 9. Johansen K, Daines M, Howey T, Helfet D, Hansen ST Jr. Objective criteria accurately predict amputation following lower extremity trauma. J Trauma 1990; 30(5): 568-72. [CrossRef] 10. Mears DC, Maxwell GP, Vidal J, et al. Clinical techniques in the lower extremity. In: Mears DC, editor. External skeletal fixation. Baltimore: Wiliams&Wilikins; 1983.p.278. 11. Montegut WJ, Allen RJ. Sural artery perforator flap as an alternative for the gastrocnemius myocutaneous flap. In: Proceeding from the 90th annual scientific assembly of the southern medical association. Baltimore: MD; 1996. [CrossRef] 12. Thione A, Valdatta L, Buoro M, Tuinder S, Mortarino C, Putz R. The medial sural artery perforators Anatomic basis for a surgical plan. Ann Plast Surg 2004; 53(3): 250-5. [CrossRef] 13. Wong MZ, Wong CH, Tan BK, Chew KY, Tay SC. Surgical anatomy of the medial sural artery perforator flap. J Reconstr Microsurg 2012; 28(8): 555-60. [CrossRef] 14. Chung YJ, Kim G, Sohn BK. Reconstruction of a lower extremity soft-tissue defect using the gastrocnemius musculoadipofascial flap. Ann Plast Surg 2002; 49(1): 91-5. [CrossRef]