Retalho lateral da coxa baseado na artéria genicular lateral superior: estudo anatômico, histomorfométrico e aplicações clínicas

Abstract

SUMMARYThe lateral genicular artery flap is a fasciocutaneous flap used for knee reconstruction with low donor site morbidity.We performed an anatomical and hystomorphometrical study of the lateral genicular artery flap in eighteen fresh cadavers (thirty-six anatomical regions). Four clinical results of knee reconstruction are demonstrated.We found a constant vascular pedicle (100%), with intramuscular perforators in 40% of dissections. The perforator was situated at 7,40cm ± 2,77 above lateral condylle of the femur, between vastus lateralis muscle and the biceps femoris muscle. The pedicle measured 6,09 ± 1,91 cm of lenght from the popliteal artery.This flap was done and succeded in four patients.This flap showed constant anatomy and is reliable for coverage of defects at superior and lateral portions of the knee and the proximal part of the lower leg.

Cutaneous angiosome of the chimeric SLGA perforator flap: Anatomical study and clinical considerations

“…1 Zumiotti et al measured the pedicle length of cutaneous perforators from the "identifiable portion in the subcutaneous tissue" up to the popliteal artery as 6.1 ± 1.9 cm. 12 The current study has found pedicle lengths between 7.5 and 12.2 cm when measuring from the origin of the vessel at the popliteal artery up to the piercing point of the perforator at the deep fascia. Considering the additional length of perforators, it is expected to find longer pedicles for the fasciocutaneous flap than for the condyle flap.…”

“…The flap may, however, not be applicable for extensive lesions of the medial and distal areas around the knee, where the flap size and arc of rotation can be insufficient for proper coverage. 7,12 The size of the artery and accompanying veins has proven to be sufficient for microanastomosis in free flaps. In our anatomical study, the average diameter of the SLGA was found to be 2 mm, slightly larger than that of the artery of the medial femoral condyle flap.…”

The superior lateral genicular artery flap for reconstruction of knee and proximal leg defects

“…Among the 28 lower limbs dissected by Nguyen et al 7 , there were, on average, 1.89 perforators per limb. A study by Zumiotti et al 6 found that in 36 lower limbs 40% of the perforators followed an intramuscular course. In the study by Nguyen et al 7 , the mean distance of perforators from the superolateral patella was 5.3 cm, while Zumiotti et al 6 reported a mean distance of 7.4 cm from the lateral condyle of the femur ( Fig.…”

“…In 2005, Zumiotti et al 6 conducted a study to verify the anatomical reliability of the flap and performed the flap successfully in four patients. Nguyen et al 7 conducted a similar study in 2011 that clearly mapped the perforator territories in relation to standard bony landmarks.…”

“…A review of the literature was conducted utilizing PubMed, with the keywords “superior,” “lateral,” “genicular,” and “artery.” Twelve articles pertaining to the use of the SLGA flap were identified: two cadaveric studies 8 9 , four combined cadaveric studies and case series 3 5 6 7 , three case series 1 10 11 and three case reports 12 13 14 . Data pertaining to anatomy, patient characteristics, etiology, surgical details, and complications were compiled and the results were summarized ( Tables 1 Tables 2 3 ).…”