Issue |
SICOT-J
Volume 10, 2024
Special issue: "Bone and joint infections"
|
|
---|---|---|
Article Number | 27 | |
Number of page(s) | 9 | |
Section | Lower Limb | |
DOI | https://doi.org/10.1051/sicotj/2024025 | |
Published online | 13 August 2024 |
Original Article
Coverage of lateral soft tissue defects with sartorius muscle flap after distal femoral replacement for malignant bone tumors
1
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho, Kashihara City, Nara 634-8521, Japan
2
Department of Rehabilitation Medicine, Nara Medical University, Nara, Japan
3
Department of Orthopaedic Oncology, IRCCS Rizzoli Institute, Bologna, Italy
4
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
* Corresponding author: shinji104@mail.goo.ne.jp
Received:
7
May
2024
Accepted:
2
July
2024
Introduction: To prevent infection after limb-sparing surgery for primary malignant bone tumors, it is important to cover the megaprosthesis with muscle tissue that has sufficient blood flow. Coverage with a lateral gastrocnemius flap has been reported in cases of distal femoral replacement in which the vastus lateralis and vastus intermedius muscles have been resected; however, the risk of peroneal nerve palsy is reportedly high because the muscle flap passes near the peroneal head. This study was performed to examine the postoperative outcomes of patients with primary malignant bone tumors of the distal femur who underwent wide resection (including the vastus lateralis and vastus intermedius muscles) followed by reconstruction with a megaprosthesis and coverage of the lateral side of the prosthesis with a sartorius muscle flap. Methods: We retrospectively analyzed three patients who underwent reconstruction with a megaprosthesis after wide resection of a primary malignant bone tumor of the distal femur involving the vastus lateralis and vastus intermedius muscles and reconstruction of the soft tissue defect on the lateral side of the prosthesis with a sartorius muscle flap. Results: The average defect size was 6 × 13 cm, the average time required for a sartorius muscle flap was 100 min, and the average implant coverage was 93%. The average postoperative follow-up period was 35 months, during which no postoperative complications such as infection, skin necrosis, or nerve palsy occurred. Discussion: The distally based sartorius muscle flap is easy to elevate in the supine position, has minimal functional loss after harvesting, and has minimal risk of nerve palsy. It can be advocated as the first option for coverage of soft tissue defects lateral to distal femoral replacement.
Key words: Sartorius muscle flap / Bone tumor / Distal femur / Megaprosthesis / Infection / Soft tissue defect
© The Authors, published by EDP Sciences, 2024
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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