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Gastrocnemius muscle flap

Alice Mayoly, Jean-Camille Mattei, Pierre Moullot, Charlotte Jaloux, Alexandre Rochwerger, Dominique Casanova, Baptiste Bertrand, Cécile Philandrianos
INTRODUCTION: The gastrocnemius muscular flap has already proven its efficiency for soft tissue coverage in cases of knee joint exposure. However, it may be too small to cover large defects and has not the same aesthetic and mechanical properties as normal skin. Perforator fasciocutaneous flaps have recently been described in knee joint coverage with good results as they replace skin by skin, but they can be hard to harvest. Gastrocnemius flaps can be easily harvested with a planned skin paddle designed over the chosen muscle...
May 14, 2018: Annals of Plastic Surgery
Barbara M Ling, Reto Wettstein, Daniel Staub, Dirk J Schaefer, Daniel F Kalbermatten
BACKGROUND: The gastrocnemius muscle flap may be considered the first choice in many cases of soft-tissue reconstruction about the knee. Limited arc of rotation and reach of the flap as well as unsightly muscle bulk are major disadvantages and were the impetus to look for a local alternative. The aim of this study is to present a consecutive series of patients with a reconstruction about the knee involving the medial sural artery perforator flap (MSAPF). METHODS: A consecutive series of 17 cases of defect reconstructions about the knee using the MSAPF is described, with an emphasis on early postoperative complications...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Jiunn-Tat Lee, Honda Hsu, Chih-Ming Lin, Chieh-Chi Huang, Sou-Hsin Chien
BACKGROUND: Endoscopic harvesting of muscle flaps is well described for gracilis, latissimus dorsi, gastrocnemius, and pectoralis major amongst others. So far there has been no description of endoscopic harvesting of the rectus femoris muscle as a free flap. The purpose of this study was to compare the perioperative outcomes of harvesting the free rectus femoris muscle flap endoscopically as compared to the standard approach. METHODS: Fifty patients with lower limb defects reconstructed with free rectus femoris muscle flap between January 2014 and December 2016 were included in this study...
December 28, 2017: Microsurgery
Tomohiro Yasuda, Masayuki Arai, Kaoru Sato, Koji Kanzaki
INTRODUCTION: In the treatment of Gustilo Type 3B open tibial fractures, it is important to perform soft tissue reconstruction and bone reconstruction simultaneously. Gastrocnemius muscle and soleus muscle flaps are generally used as rotational flaps for the tibia. The distal third of the tibia can often not be covered with the gastrocnemius muscle and soleus muscle flaps. Treatment distal to the distal third of the tibia is difficult because fewer flap options are available. In the present report, we describe our experience with a Gustilo Type 3B open tibial fracture treated by gastrocnemius muscle and soleus muscle flaps, along with an additional proximally based flexor hallucis longus flap, which is a rare procedure...
March 2017: Journal of Orthopaedic Case Reports
B Tosun, O Selek, U Gok, O Tosun
OBJECTIVE: Unhealed amputation stumps after transtibial amputation are common and often require reamputation futher up the leg. The aim of our study is to describe our experience with medial gastrocnemius muscle flap coverage following a transtibial amputation. METHOD: We retrospectively examined the records of patients who had an unhealed transtibial amputation stump who were then treated with a medial gastrocnemius muscle flap. RESULTS: We identified seven patients, all had diabetes mellitus and an initial amputation by the long posterior flap technique...
August 2, 2017: Journal of Wound Care
Benjamin T Himes, Thomas J Wilson, Andres A Maldonado, Naveen S Murthy, Robert J Spinner
The authors present a case of delayed peroneal neuropathy following a lateral gastrocnemius rotational flap reconstruction. The patient presented 1.5 years after surgery with a new partial foot drop, which progressed over 3 years. At operation, a fascial band on the deep side of the gastrocnemius flap was compressing the common peroneal nerve proximal to the fibular head, correlating with preoperative imaging. Release of this fascial band and selective muscle resection led to immediate improvement in symptoms postoperatively...
July 28, 2017: Journal of Neurosurgery
Kosuke Hamahashi, Yoshiyasu Uchiyama, Yuka Kobayashi, Masahiko Watanabe
BACKGROUND: Pin tract infection is a common complication of external fixation. It usually heals after treatment with debridement, antibiotics, and/or pin removal, only rarely developing into delayed osteomyelitis. We treated two patients with delayed methicillin-resistant Staphylococcus aureus-induced osteomyelitis of the tibia following pin tract infection. CASE PRESENTATION: One patient, a diabetic 60-year-old Japanese man, underwent definitive external fixation using an Ilizarov fixator for postoperative osteomyelitis of an open fracture of his left ankle...
January 31, 2017: Journal of Medical Case Reports
Malou C van Zanten, Raakhi M Mistry, Hiroo Suami, Andrew Campbell-Lloyd, James P Finkemeyer, Neil B Piller, Yugesh Caplash
BACKGROUND: Severe compound tibial fractures are associated with extensive soft-tissue damage, resulting in disruption of lymphatic pathways that leave the patient at risk of developing chronic lymphedema. There are limited data on lymphatic response following lower limb trauma. Indocyanine green fluorescence lymphography is a novel, real-time imaging technique for superficial lymphatic mapping. The authors used this technique to image the superficial lymphatic vessels of the lower limbs in patients with severe compound tibial fracture...
February 2017: Plastic and Reconstructive Surgery
Mahir Aliyev, Andaç Aykan, Muhitdin Eski, Nuri Arslan, Bülent Kurt, Mustafa Şengezer
BACKGROUND: Based on the angiogenetic and stimulating effects of bone healing and formation of vascular endothelial growth factor (VEGF), the present study was designed to assess the efficacy of VEGF gene application in the management of experimentally induced osteomyelitis. METHODS: Thirty-two male Sprague Dawley rats were divided into 4 groups, and osteomyelitis was induced in the left tibial bones. Group 1 (n=8) was designated as a control group, and, after the induction of osteomyelitis, no treatment was applied for a period of 4 weeks...
May 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Hamza Ozer, Hakan Y Selek, Gulcan Harput, Ali Oznur, Gul Baltaci
The aim of the present study was to investigate the outcomes after open repair of Achilles tendon rupture augmented with a distal turndown gastrocnemius flap and deep posterior crural fasciotomy based on the modified Lindholm technique. Twenty-three patients with acute Achilles tendon injury underwent open end-to-end tendon repair augmented with a distal turndown gastrocnemius flap and deep posterior compartment fasciotomy. The concentric and eccentric muscle strength was measured using a functional squat system, and dynamic balance was assessed using the Y-balance test with anterior, posteromedial, and posterolateral reach distances...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Guangfeng Sun, Kaiyu Nie, Jianping Qi, Wenhu Jin, Shujun Li, Ziyang Zhang, Zairong Wei, Dali Wang
OBJECTIVE: To investigate the effectiveness of the free medial sural artery perforator flap for repairing anterior dorsal foot wound. METHODS: Between January 2010 and April 2015, 16 patients with skin and soft tissue defects of the anterior foot dorsal side were treated. There were 12 males and 4 females with the average age of 35 years (mean, 16-58 years). The disease causes included burn in 5 cases, traffic accident injury in 8 cases, and crush injury in 3 cases...
March 2016: Chinese Journal of Reparative and Reconstructive Surgery
Pawan Agarwal, K L Gupta, P Yadav, Dhananjaya Sharma
INTRODUCTION: Gastrocnemius muscle is a workhorse flap to cover upper third tibial defects but has a limitation in covering middle one-third tibial defects. The inferiorly based hemi gastrocnemius muscle flap can be useful for reconstruction of the middle third of the leg. The arterial communication between the gastrocnemius muscle heads has been demonstrated, the consistent location, however, was not studied in large specimens. MATERIALS AND METHODS: This study was conducted on sixty specimens of gastrocnemius muscles harvested from thirty fresh cadavers to determine arterial communication between two heads of gastrocnemius muscle using radio-opaque contrast with future application of taking one head of muscle distally based for coverage of middle third defect of tibia...
January 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
U Nöth, M Trojanowski, J C Reichert, O Rolf, L Rackwitz
BACKGROUND: Ruptures of the patellar tendon after total knee arthroplasty represent a rare but severe complication, which in general requires surgical therapy. OBJECTIVES: To implement a classification and correspondent therapy algorithm in consideration of the current literature for the treatment of patellar tendon ruptures after TKA. MATERIAL AND METHODS: A review of the recent literature and the author's experience are summarized in a classification and correspondent therapy algorithm for the treatment of patellar tendon ruptures after TKA...
May 2016: Der Orthopäde
G Zulueta La Rosa, E S Steinhausen, P H Hax, M Glombitza
The primary objective of osteomyelitis treatment is disinfection. Therapies can be protracted and expensive. The basic approach is to use radical debridement with antibiotics. However, radical debridement often results in major osseous defects, so it may be necessary to restore bone structures. Several different therapies have been described. Disinfection may be influenced by tissue perfusion. A muscle flap may effectively make good the loss of osseous tissue. In any case, autologous material is limited and the procedure must be adapted to the individual patient...
April 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Lei Yang, Xin Tang, Qi Li, Gang Chen, Weili Fu, Hai Jiang, Yanqing Hu, Jian Li
OBJECTIVE: To investigate the methods and the effectiveness of arthroscopic treatment combined with repair of the cyst wall using the tendon flap of medial head of gastrocnemius muscle after resection of popliteal cyst. METHODS: A retrospective analysis was made on the clinical data of 140 patients with popliteal cyst between August 2009 and June 2014, including 44 males and 96 females with a mean age of 54.68 years (range, 14-80 years). The median course of symptoms was 31 months (range, 20 days to 30 years)...
December 2015: Chinese Journal of Reparative and Reconstructive Surgery
Gregory A Lamaris, Michael P Carlisle, Paul Durand, Rafael A Couto, Mark F Hendrickson
BACKGROUND: The medial gastrocnemius muscle flap is commonly used for the reconstruction of defects around the knee and proximal leg. The flap can be raised using either a medial or a posterior midline incision, although no studies have been done comparing the 2 different surgical approaches. METHODS: We compared the reach of the medial gastrocnemius muscle flap using either of the 2 incisions in a series of 25 fresh cadavers. All muscle flaps were elevated without division of the muscle origin...
March 2017: Annals of Plastic Surgery
M Bonnin, S Lustig, D Huten
Extensor tendon rupture is a rare but serious complication after total knee arthroplasty (TKA) that impairs active knee extension, thereby severely affecting knee function. Surgery is usually required. Surgical options range from simple suturing to allograft reconstruction of the entire extensor mechanism and include intermediate methods such as reconstruction using neighbouring tendons or muscles, synthetic ligament implantation, and partial allograft repair. Simple suturing carries a high failure rate and should therefore be routinely combined with tissue augmentation using a neighbouring tendon or a synthetic ligament...
February 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Samuel Lance, Lindsey Harrison, Hakan Orbay, David Boudreault, Gavin Pereira, David Sahar
The use of negative-pressure wound therapy (NPWT) for management of open wounds and immobilization of split-thickness skin grafts (STSGs) over wounds has been well described. However, there is a concern for potential compromise of flap viability when NPWT is used for skin grafts over pedicled muscle flaps. We have used NPWT to immobilize STSGs in eight patients who underwent a pedicled gastrocnemius muscle flap operation in our department. We applied a negative pressure of -75 mmHg on the muscle flaps for 5 days postoperatively...
April 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Yuming Shen, Chunxu Ma, Xiaohua Hu, Cheng Wang, Cong Zhang
OBJECTIVE: To explore selection and method of tissue flaps for the repair of severe defects of skin and soft tissue around the knee joints. METHODS: Fifty-four patients with wounds around the knee joints, all accompanied by exposure or necrosis of tendon or bone and exposure of prosthesis, were hospitalized in our burn center from June 2008 to December 2014. Five of them were with knee joint injury. After thorough debridement or tumor resection, the wound area ranged from 5 cm × 5 cm to 46 cm × 22 cm...
October 2015: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Xiaoyuan Huang
This article briefly summarizes the techniques for repair of skin and soft tissue defects around the knee joints as reported in 5 papers in this issue, including how to choose the skin flap, muscle flap, myocutaneous flap, and vascular anastomosis in recipient site. It is found that the anterolateral femoral flap, latissimus dorsi myocutaneous flap, and gastrocnemius flap are widely used in clinic with high survival rates, and they can be used for the repair of large soft tissue defects as well as the reconstruction of the knee joint function...
October 2015: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
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