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Engineered Vascularized Muscle Flap
Published on: January 11, 2016
The composite anterolateral thigh flap for knee extensor and skin reconstruction
Seung Han Song1, Sangmun Choi, Young-Mo Kim
1Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, 640 Daesa-dong, Daejeon, Jung-gu, 301-721, South Korea.
Archives of Orthopaedic and Trauma Surgery
|August 27, 2013
Summary
This study presents a successful knee reconstruction using a composite anterolateral thigh (ALT) flap. The technique restored both skin integrity and the extensor mechanism after patella removal, enabling normal knee function.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Biomaterials in Medicine
Background:
- Reconstructing knee defects after total patellectomy, especially with significant skin loss, presents a surgical challenge.
- The loss of the patella and extensor mechanism compromises knee function and stability.
Observation:
- A 31-year-old male patient with a large skin defect and absent patella following infected open patellar fracture surgery was treated.
- A composite anterolateral thigh (ALT) flap, incorporating vascularized skin and fascia lata (FL), was utilized for reconstruction.
Findings:
- The fascia lata (FL) component of the ALT flap was folded and attached to the remaining patellar tendon, reconstructing the extensor mechanism.
- The skin portion of the flap successfully covered the 9x10 cm skin defect.
- The patient experienced uneventful wound healing and achieved a 0°-120° active range of motion at 30 months post-surgery.
Implications:
- The composite ALT flap offers a viable solution for simultaneous skin and extensor mechanism reconstruction in complex knee injuries.
- This approach can restore normal knee extension strength and functional mobility, including weight-bearing and ambulation.
- The study highlights the composite ALT flap as a valuable reconstructive option for post-patellectomy knee deficits.
