Reconstruction of complex soft-tissue defects around the knee joint with distally based split vastus lateralis musculocutaneous flap: a new technique.
AIMS
The aim of this study was to report our experience of using distally based spilt vastus lateralis musculocutaneous flaps for soft-tissue defects around the knee joint - a new technique.


MATERIAL AND METHODS
Cadaver dissection studies were conducted in three cadavers to demonstrate perforators entering the lower third of the vastus lateralis muscle arising from the superior lateral genicular artery. Its application in eight clinical cases for the reconstruction of soft-tissue defects around the knee joint is reported.


RESULTS
Seven out of eight flaps survived well without any flap loss. One flap with a skin island measuring 12 × 20 cm suffered a loss of 2 cm distally. This was later treated with skin grafting. Six out of eight donor sites were closed primarily. Six patients achieved full functional range of motion by 3 months. One patient had a 10° limitation of knee extension. One patient had foot drop due to primary injury and walks with a limping gait.


CONCLUSIONS
This flap is a new reconstructive option for knee defects. It can reach distally up to the tibial tuberosity and does not require an intraoperative change of position. The donor site can be closed primarily and is hidden inside the clothing. The function of the knee is not affected as the majority of the muscle is kept in continuity.
['Sahasrabudhe|P|P|', 'Panse|N|N|', 'Baheti|B|B|', 'Jadhav|A|A|', 'Joshi|N|N|', 'Chandanwale|A|A|']
D000328:Adult D015331:Cohort Studies D005260:Female D005500:Follow-Up Studies D006084:Graft Rejection D006085:Graft Survival D006801:Humans D007194:India D015601:Injury Severity Score D007719:Knee Joint D008297:Male D008875:Middle Aged D064827:Myocutaneous Flap D052097:Quadriceps Muscle D012189:Retrospective Studies D018570:Risk Assessment D012867:Skin D017695:Soft Tissue Injuries D013997:Time Factors D016896:Treatment Outcome D014945:Wound Healing
Vastus lateralis musculocutaneous flap Distally based flap Periarticular knee defects Superior lateral genicular artery perforators