Complications of Muscle-Flap Transposition for Traumatic Defects of the Leg

Neale, Henry W.; Stern, Peter J.; Kreilein, Joel G.; Gregory, Richard O.; Webster, Karen; Vásconez, Luis O.

doi:10.1097/00006534-198310000-00018

Cited by 6 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 a A 10-year-old male patient with soft tissue defect in lateral aspect of right knee with exposed bone after motor car accident. knee joint with inconsistent and unsatisfactory results [9,10]. These unsatisfactory results may be referred to the difficult full free mobilization of the reconstructing tissue unit(s) or due to the unavailability of supple enough local tissues for complete coverage.…”

Section: Discussionmentioning

confidence: 99%

Practical guidelines for getting the most out of the gastrocnemius muscle flap units: a presented algorithm for the best flap choice

El-Shazly

Kamal

2012

Eur J Plast Surg

View full text Add to dashboard Cite

Although with the reported versatility, vascular reliability, and easy harvesting and elevation of the gastrocnemius muscle flap, still it is used for a narrow aspect of reconstructions including only small and nearby defects. The flap is unfortunately full of limited applications, unreachable coverage, and soft tissue shortage. In this work, we are presenting 20 cases of gastrocnemius muscle flap of different etiologies, in which we applied a group of modifications to have a higher grade of applicability, more arc of rotation, and more tissue surface area. The validity of these modifications was intraoperatively tested in different defect sites and sizes to report if they are really meaningful. All flaps had survived with no complications. We have summarized these modifications in four golden rules, making these muscle flaps more versatile and more applicable. An algorithm is suggested as a leading tool for the best choice of the gastrocnemius muscle units in different situations.

show abstract

Section: Discussionmentioning

confidence: 99%

Practical guidelines for getting the most out of the gastrocnemius muscle flap units: a presented algorithm for the best flap choice

El-Shazly

Kamal

2012

Eur J Plast Surg

View full text Add to dashboard Cite

show abstract

“…However, these local muscle flaps are often less versatile than a soleus muscle flap for coverage of a tibial wound in the distal third of the leg, based on the author's experience, and would have a higher rate of partial flap loss. 18 Distant skin island flaps, such as reversed sural artery flap, 14,19,20 can also be used to provide soft-tissue coverage in above anatomic region. However, the less optimal blood supply provided by a fasciocutaneous flap has been one of the main concerns for its routine use in soft-tissue coverage of an open tibial wound in the distal third of the leg associated with an underlying tibial fracture.…”

Section: Discussionmentioning

confidence: 99%

Soft-Tissue Reconstruction of an Open Tibial Wound in the Distal Third of the Leg

2007

Annals of Plastic Surgery

View full text Add to dashboard Cite

Over the past 4 years, a total of 33 patients, each with an open tibial wound in the distal third of the leg, underwent a skin-grafted muscle flap reconstruction according to the new treatment algorithm developed by the author. When the size of the soft-tissue defect was less than 50 cm, a pedicled medial hemisoleus muscle flap was used for the soft-tissue coverage (n = 20). If the soleus muscle was traumatized, a small free muscle flap (ie, gracilis) was then used (n = 3). When the size of the soft-tissue defect was greater than 50 cm, a larger free muscle flap (ie, rectus abdominis or latissimus dorsi) was selected (n = 10). All patients were followed for up to 4 years. Three patients with a medial hemisoleus muscle flap developed insignificant distal flap necrosis and were treated subsequently with debridement and flap advancement. Five patients with a free muscle flap required an additional operation, and 2 patients had a subsequent debulking procedure of the flap for contour improvement of the leg. Reliable soft-tissue coverage with a well-healed tibial wound, evident fracture healing, and good contour of the leg were achieved in all 33 patients during follow-up. Following this new treatment algorithm, a selected option for an open tibial wound in the distal third of the leg can provide reliable soft-tissue coverage for different sizes of open tibial wounds and may offer a more cost-effective approach for managing such a complex clinical problem.

show abstract

“…Distally based pedicle flaps such as the sural flap, the peroneal flap, and the saphenous flap can only close small defects, and their use is often precluded after damage to the vascular pedicle in the initial injury. 38 The foot and ankle region is a domain of the free tissue transfer, which is in line with the rule of thirds for the lower extremity, which states that defects in the proximal third of the tibia can be addressed by the gastrocnemius flap, defects of the middle third of the tibia are optional for the soleus flap, but that defects of the lower third of the tibia are better treated with a free flap. 39 Sir Harold Gillies, considered as one of the fathers of modern reconstructive plastic surgery, used the motto "replace like with like."…”

Section: Soft Tissue Reconstructionmentioning

confidence: 90%

The Orthoplastic Approach for Management of the Severely Traumatized Foot and Ankle

Heitmann

Levin

2003

The Journal of Trauma: Injury, Infection, and Critical Care

View full text Add to dashboard Cite

Complications of Muscle-Flap Transposition for Traumatic Defects of the Leg

Cited by 6 publications

References 0 publications

Practical guidelines for getting the most out of the gastrocnemius muscle flap units: a presented algorithm for the best flap choice

Practical guidelines for getting the most out of the gastrocnemius muscle flap units: a presented algorithm for the best flap choice

Soft-Tissue Reconstruction of an Open Tibial Wound in the Distal Third of the Leg

The Orthoplastic Approach for Management of the Severely Traumatized Foot and Ankle

Contact Info

Product

Resources

About