Rectus femoris muscle flap donor-site morbidity

Gardetto, Alexander; Raschner, Ch.; Schoeller, Thomas; Pavelka, Michaela; Wechselberger, Gottfried

doi:10.1016/j.bjps.2004.08.001

Cited by 35 publications

(21 citation statements)

References 11 publications

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“…Despite the significant loss of force, however, baseline level of function and active range of motion of the knee and hip were reportedly unaffected. These findings are consistent with those of Gardetto et al [15] who suggested that harvest of the rectus femoris flap had no clinically significant donor site morbidity and did not adversely affect the patient's capacity for everyday activity.…”

Section: Discussionsupporting

confidence: 92%

Functional Reconstruction of a Combined Tendocutaneous Defect of the Achilles Using a Segmental Rectus Femoris Myofascial Construct: A Viable Alternative

2014

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The composite anterolateral thigh flap with vascularized fascia lata has emerged as a workhorse at our institution for complex Achilles defects requiring both tendon and soft tissue reconstruction. Safe elevation of this flap, however, is occasionally challenged by absent or inadequate perforators supplying the anterolateral thigh. When discovered intraoperatively, alternative options derived from the same vascular network can be pursued. We present the case of a 74-year-old male who underwent composite Achilles defect reconstruction using a segmental rectus femoris myofascial free flap. Following graduated rehabilitation, postoperatively, the patient resumed full activity and was able to ambulate on his tip-toes. At 1-year follow-up, active total range of motion of the reconstructed ankle exceeded 85% of the unaffected side, and donor site morbidity was negligible. American Orthopaedic Foot and Ankle Society and Short Form-36 scores improved by 78.8% and 28.8%, respectively, compared to preoperative baseline assessments. Based on our findings, we advocate for use of the combined rectus femoris myofascial free flap as a rescue option for reconstructing composite Achilles tendon/posterior leg defects in the setting of inadequate anterolateral thigh perforators. To our knowledge, this is the first report to describe use of this flap for such an indication.

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Section: Discussionsupporting

confidence: 92%

Functional Reconstruction of a Combined Tendocutaneous Defect of the Achilles Using a Segmental Rectus Femoris Myofascial Construct: A Viable Alternative

2014

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“…In general, strength differences in normal populations or athletes can reach up to 10%, for example, in leg strength due to leg dominance or earlier leg injuries [17,18]. It is not yet known if this is also true for shoulder or shoulder girdle strength.…”

Section: Discussionmentioning

confidence: 97%

Funktionelles Resultat und biomechanische Untersuchungen nach Tumor-Resektion im Bereich des Schultergürtels (Fallbericht)

et al. 2009

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Zusammenfassung. Grundlagen: Es wird ein 20-jähriger Mann vorgestellt, der wegen eines ausgedehnten Desmoidtumors im Schulterbereich marginal reseziert worden ist und intra-und postoperativ nachbestrahlt wurde.Methodik: Weite Teile des Schultergürtels waren von Tumorgewebe infiltriert weshalb der ventrale Teil des M. deltoideus, zwei Drittel des M. pectoralis major, der M. pectoralis minor, das Schlüsselbein und Teile der Kapsel des Schultergelenks entfernt wurden. Die Rekonstruktion der Muskelfunktion erfolgte durch einen gesplitteten M. latissimus dorsi, welcher mit Meshgraft bedeckt wurde.Ergebnisse: 3 Jahre postoperativ ist der Mann als Bäcker voll berufstätig, lediglich die Adduktion ist durch das Fehlen des Schlüsselbeins eingeschränkt. Am Institut für Sportwissenschaft wurde die globale Schulterfunktion gemessen und das klinisch gute Ergebnis bestätigt.Schlussfolgerungen: Ausgedehnte Tumorresektionen im Schulterbereich sind heute bei guter Planung und radikaler Durchführung der Operation mit einzeitiger Rekonstruktion und sehr früh postoperativ eingesetztem Rehabilitationsprogramm möglich. Sportmedizinische Messungen der globalen Schulterfunktion können zur Optimierung des Rehabilitationsprogramms wertvolle Hinweise liefern. Schlüsselwörter: Tumor, Schultergü rtel, Rekonstruktion, gesplitteter M. latissimus dorsi-Lappen, funktionelles Ergebnis, biomechanische Untersuchungen. Summary. Background: A 20-year-old male with a large extra-abdominal fibromatosis of the left shoulder girdle underwent marginal tumor resection, postopoperative radiation therapy and reconstruction with a split latissimus dorsi flap.Methods: Owing to the tumor involving major parts of the shoulder girdle, the clavicular part of the deltoideus and cranial parts of the pectoralis major and pectoralis minor muscle, parts of the coracobrachial muscle, the clavicle and the coracoid process had to be resected. The reconstruction of the different muscles was performed with a split latissimus dorsi muscle (LD) covered with mesh graft. The LD flap was chosen for its size, ability for compartmentalization, arc of rotation, vascularization and innervation and minimal donor-site morbidity. Owing to the marginal resection of the tumor, intra-and postoperative radiation therapy followed.Results: The patient has regained excellent function in his left upper extremity and is able to continue his profession as a baker with the exception of adduction being weaker than the contralateral side caused by the missing clavicle.Conclusions: The transfer of a split latissimus dorsi muscle is an effective procedure to cover defects and restore muscles with different function after extended tumor resection in the region of the shoulder girdle. The functional outcome is excellent and measurements by sport scientists are able to gain valuable results for optimizing the rehabilitation program.

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“…A RF muscle flap is suggested for reconstructing groin defects > 10 cm wide, although it was suspected that this might decreases the strength of the knee extensors. However, Gardetto et al suggested that there was no difference in the extensor function of the graft donor leg and the untreated leg [21]. The sartorius muscle flap has the advantages of being immediately adjacent to the groin, ease of preparation, and causing minimal functional morbidity when harvested.…”

Section: Discussionmentioning

confidence: 98%

Management of Infected Groin Wounds after Vascular Surgery

Shih

Cheng

et al. 2013

Surgical Infections

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A pedicled flap of gracilis muscle is an ideal and effective option for covering infected groin wounds of <10 cm with exposure of femoral vessels. According to a literature review, a sartorius muscle flap is another option for accomplishing this. A myocutaneous island flap of the ALT is indicated for infected groin wounds>10 cm with exposure of femoral vessels. The literature indicates that myocutaneous flaps of rectus abdominis (RA) muscle and flaps of rectus femoris (RF) muscle are also suitable for groin wounds larger than 10 cm. Bilateral flaps of ALT and bilateral myocutaneous flaps of RA or RF muscle are suggested for the reconstruction of bilateral groin wounds. For infected groin wounds without exposure of femoral vessels, a local flap or primary closure are suggested, depending on the size of the defect.

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Rectus femoris muscle flap donor-site morbidity

Cited by 35 publications

References 11 publications

Functional Reconstruction of a Combined Tendocutaneous Defect of the Achilles Using a Segmental Rectus Femoris Myofascial Construct: A Viable Alternative

Functional Reconstruction of a Combined Tendocutaneous Defect of the Achilles Using a Segmental Rectus Femoris Myofascial Construct: A Viable Alternative

Funktionelles Resultat und biomechanische Untersuchungen nach Tumor-Resektion im Bereich des Schultergürtels (Fallbericht)

Management of Infected Groin Wounds after Vascular Surgery

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