Grafts, Flaps, and Microsurgery

Clinical Flaps

Reversed Gracilis Pedicle Flap for Coverage of a Total Knee Prosthesis

Tiengo C, Macchi V, Vigato E, et al (Univ of Padova, Italy) J Bone Joint Surg Am 92:1640-1646, 2010^§

Abstract

Background

Poor wound-healing and skin necrosis are potentially devastating complications after total knee arthroplasty. Primary soft-tissue coverage with a medial or lateral gastrocnemius transposition flap is typically the first choice for reconstruction. The aim of this study was to evaluate the use of a distally based secondary-pedicle flap of the gracilis muscle for reconstruction of a soft-tissue defect.

Methods

The characteristics of the distally based (secondary) pedicles of the gracilis muscle were studied with use of dissection (ten cadavers) and computed tomographic angiograms (fifty patients). On the basis of the anatomical features, an extended reversed gracilis flap based on the secondary pedicles was used in three patients with severe soft-tissue complications of total knee arthroplasty.

Results

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