A cadaveric analysis of the blood supply to rectus Femoris

Williams, Matthew; Caterson, Jessica; Cogswell, Lucy; Gibbons, C. L. M. H.; Cosker, Thomas

doi:10.1016/j.bjps.2018.12.045

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…A good understanding of the vascular anatomy of the RF indicates that a VL and VI MC flap is superior to a three‐muscle flap. Sun et al carried out a cadaveric study on the origin of the rectus femoris branch (RFB) and found 66.7% of the RFB originating from the descending branch of the LCFA, whereas 11.1% originates from the SFA and 11.1% from the LCFA directly 12–14 . Even when the ascending branch of the LCFA is the main source vessel, it provides blood supply to the proximal portion of the muscle, whereas the muscular branches of the SFA specifically supply the distal third.…”

Section: Discussionmentioning

confidence: 99%

“…Sun et al carried out a cadaveric study on the origin of the rectus femoris branch (RFB) and found 66.7% of the RFB originating from the descending branch of the LCFA, whereas 11.1% originates from the SFA and 11.1% from the LCFA directly. 12 , 13 , 14 Even when the ascending branch of the LCFA is the main source vessel, it provides blood supply to the proximal portion of the muscle, whereas the muscular branches of the SFA specifically supply the distal third. RFB perforators run either an intramuscular or septocutaneous course through the RF, changing into AMT perforators that further supply the overlying skin territory on medial thigh.…”

Section: Discussionmentioning

confidence: 99%

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Vastus Lateralis and Vastus Intermedius Myocutaneous Flap Reconstruction for Complicated Trochanteric and Ischial Pressure Sores with Extended Girdlestone Resection: A Case Series

Ryoo,

Park,

Kim

2023

Orthopaedic Surgery

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ObjectiveMost paraplegic patients with complicated trochanter sores or ischial sores present with lower limb muscle atrophy. Therefore, in patients who have undergone Girdlestone arthroplasty, filling the dead space and replacing the volume defect through an appropriate surgical technique is extremely challenging. This study presents a case series of vastus lateralis and vastus intermedius myocutaneous flap reconstruction after extended proximal femoral osteotomy in paraplegic patients. The aim of study is to investigate (i) whether sufficient volume replacement was achieved, (ii) whether muscle volume was maintained during long‐term follow‐up, and (iii) the presence of donor site morbidity.MethodA retrospective review was conducted with eight patients who underwent this method from March 2017 to December 2021. A total of nine flaps was elevated, and the defect was successfully reconstructed without dead space. Computed tomography was performed to identify the changes in thickness and volume of the muscle portion. The Wilcoxon signed‐rank test was performed to assess the significance of the differences in muscle thickness between pre‐ and post‐measurements.ResultsAfter surgery, all patients healed within 1 month; three patients experienced minor complications. The average follow‐up period was 14.5 months, during which only one patient with an ischial pressure ulcer developed wound disruption and recurrence. The average thickness of the rotated muscle was 51.95 mm at 2 to 4 weeks postoperatively and 53.07 mm at 6 months postoperatively (𝑝 = 0.071).ConclusionAll nine cases healed well without major complications. When comparing the volume of the rotated muscle on radiological examinations before and after surgery, no significant differences were observed. Our modified Girdlestone resection technique provides a simple and reliable method for reconstructing complex trochanteric or ischial sores in paraplegic patients. It ensures anatomical consistency, ample volume, and structural stability by leaving the rectus femoris (RF) in place. Careful tension management is required when using this flap in the ischial area.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vastus Lateralis and Vastus Intermedius Myocutaneous Flap Reconstruction for Complicated Trochanteric and Ischial Pressure Sores with Extended Girdlestone Resection: A Case Series

Ryoo,

Park,

Kim

2023

Orthopaedic Surgery

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“…It remains controversial whether this may compromise the blood supply of the rectus femoris muscle (RFM) [32][33][34]. Based on cadaveric-based anatomical studies, the RFM is also supplied proximally by the super cial circum ex iliac artery and distally by the superior lateral genicular artery [35,36]. Thus, ligation of one or two RFBs of the LCFA should be relatively safe.…”

Section: Casementioning

confidence: 99%

Reconstruction of Complex Soft-Tissue Defects in Buttock Using The Proximally Based Anterolateral Thigh Flap: An Alternative Algorithm

Wang

Zang

Zhu

et al. 2021

Preprint

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Background Local and free flaps are most widely used in buttock reconstruction. However, local flaps and free flaps may not be appropriate for all complex soft tissue defects in buttock. In this study, we propose an alternative approach for buttock reconstruction and provide preliminary assessment in clinical efficacy of using a proximally based anterolateral thigh flap for buttock reconstruction. Methods In this study, we retrospectively analyzed the data of the patients with medium- to large-sized defects of buttock. All patients underwent buttock defect reconstruction using a proximally based anterolateral thigh flap between August 2012 and December 2020. Results Eight pedicled anterolateral thigh flaps were used to reconstruct buttock defects after tumor ablation in six patients, scar revision in one patient, melanocytic nevus resection in one patient. Flap size ranged from 25 × 8 cm to 30 × 12 cm, with pedicle length ranging from 12 to 20 cm. Flaps were elevated based on the distal musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery and completely survived without any perfusion-related complications. We achieved satisfactory results from both the functional and aesthetic point-of-view at the 6-month follow-up in all cases. Conclusions The proximally based anterolateral thigh flap can be a valuable reconstructive option with sufficient tissue and a long vascular pedicle for buttock defect reconstruction.

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“…The predominant function of this muscle group is to extend the knee, with RF having a secondary function of hip flexion. RF receives its blood supply from the descending branch of the lateral femoral circumflex (DBLFC) artery, which arises from the profunda femoris artery, the principal blood supply for the thigh muscles (Williams et al, 2019). The DBLFC artery runs through the intermuscular septum between RF and VL, accompanied by the paired venae comitantes.…”

mentioning

confidence: 99%

Vastus lateralis versus rectus femoris muscle flaps for recalcitrant hip joint infection: An anatomical study comparing the effectiveness of acetabular dead space control

et al. 2022

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Eliminating recalcitrant prosthetic hip joint infections remains one of the greatest challenges in orthopedic surgery. In such cases, the salvage procedure of femoral head excision (the Girdlestone procedure) is often performed. There has been emerging surgical interest in filling the resulting acetabular dead space with a pedicled muscle flap, to enable antibiotic delivery. Both vastus lateralis (VL) and rectus femoris (RF) muscle flaps have been described for this purpose with good success. This study is the first anatomical investigation comparing VL and RF as candidates for interposition myoplasty following hip joint excision. Following standard surgical technique, the Girdlestone procedure and interposition myoplasty of both RF and VL were performed on 10 cadavers. The primary aim was to determine which muscle flap eliminated a greater volume of acetabular dead space. Secondary aims were to characterize the blood supply to RF and assess additional metrics indicative of the likelihood of flap success. The VL flap eliminated more dead space than RF. However, the use of the RF flap was feasible in all cases and has several benefits, including ease of harvest, mobility, and aesthetics. The location of the inferior vascular pedicle into RF was relatively consistent and the most effective predictor of flap success. Both VL and RF are effective in reducing acetabular dead space. While VL can fill a greater volume, the RF flap has technical advantages, related to the predictability of the blood supply.

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A cadaveric analysis of the blood supply to rectus Femoris

Cited by 7 publications

References 8 publications

Vastus Lateralis and Vastus Intermedius Myocutaneous Flap Reconstruction for Complicated Trochanteric and Ischial Pressure Sores with Extended Girdlestone Resection: A Case Series

Vastus Lateralis and Vastus Intermedius Myocutaneous Flap Reconstruction for Complicated Trochanteric and Ischial Pressure Sores with Extended Girdlestone Resection: A Case Series

Reconstruction of Complex Soft-Tissue Defects in Buttock Using The Proximally Based Anterolateral Thigh Flap: An Alternative Algorithm

Vastus lateralis versus rectus femoris muscle flaps for recalcitrant hip joint infection: An anatomical study comparing the effectiveness of acetabular dead space control

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