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Pelvic Floor Reconstruction Utilizing a Residual Hamstring Rotational Flap Following Traumatically Induced Subtotal
Richard L Purcell1, John P Cody1, Mary O'Donnell2
1Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889.
Objective:
There are several options for soft tissue coverage following external hemipelvectomy; however, in cases of war-related blast trauma, standard flaps are not always available as a result of the extensive soft tissue damage.
Methods:
We detail a novel closure technique following a subtotal hemipelvectomy with exposed abdominal viscera using a residual hamstring myofascial cutaneous flap.
Results:
This flap allowed for fascial tissue to fill the pelvic defect and provided excellent soft tissue coverage for future prosthetic wear.
Discussion:
In the current literature, there is limited information regarding surgical options for soft tissue coverage following traumatic hip disarticulation. Most cases result from malignancies or severe infection, where tissue distal to the lesion is viable and provides adequate coverage. This case report used a novel technique, provided excellent soft tissue coverage with no wound healing complications, allowed for excellent prosthetic fitting, and the patient's ability to ambulate without assistance.
