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Devastating massive knee defect reconstruction using the cornucopian chimera flap from the subscapular axis: two case

Kazufumi Sano1, Geoffrey G Hallock, Satoru Ozeki

  • 1Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital, Tokyo, Japan.

Journal of Reconstructive Microsurgery
|January 21, 2006
PubMed
Summary

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Multiple-island combined flaps effectively reconstruct large knee defects after osteomyelitis. This technique offers a viable solution for complex cases requiring significant tissue and bone restoration.

Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Microsurgery

Background:

  • Massive knee defects pose significant reconstructive challenges.
  • Acute osteomyelitis following high-energy fractures often necessitates aggressive debridement.
  • Restoring function and stability in such cases is paramount for patient mobility.

Observation:

  • Two cases of massive knee defects following debridement for osteomyelitis are presented.
  • Case 1 utilized a four-island combined flap with partial bone transport via the Ilizarov apparatus.
  • Case 2 employed a five-island combined flap, achieving knee joint ankylosis for painless weight-bearing.

Findings:

  • Successful three-dimensional reconstruction of destructive knee defects was achieved using multiple-island combined flaps.

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  • The subscapular axis provided a reliable vascular basis for these complex flaps.
  • The reconstructive approach facilitated functional recovery and improved patient outcomes.

    • Implications:

    • Multiple-island combined flaps represent a versatile and effective reconstructive option for extensive knee defects.
    • This technique can be tailored to address specific defect characteristics, including bone and soft tissue loss.
    • Further research may explore the long-term durability and functional outcomes of this reconstructive strategy.