The proximal vastus lateralis flap: An anatomical and radiological study

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Anatomy

Background:

• Soft-tissue reconstruction after acetabular or proximal femur resection for bone tumors presents significant challenges.
• The vastus lateralis flap is a potential option for covering soft-tissue defects in the hip region.
• Traditional flap retrieval can lead to increased morbidity.

Purpose of the Study:

• To anatomically and radiologically assess the vascularization of the proximal vastus lateralis muscle.
• To evaluate the feasibility of using the transverse branch of the lateral circumflex femoral artery for flap vascularization.
• To reduce the morbidity associated with classical vastus lateralis flap harvesting.

Main Methods:

• Dissection of five fresh adult cadavers bilaterally.
• Injection of contrast media into the lateral circumflex artery of each vastus lateralis.
• CT scan imaging and subsequent descriptive and analytical studies.

Main Results:

• The entire vastus lateralis muscle had a median surface area of 282 cm².
• The perfused area, supplied by the transverse branch of the lateral circumflex femoral artery, had a median surface area of 89.4 cm².
• The mean pedicle length measured on CT scans was 6.3 cm.

Conclusions:

• The proximal vastus lateralis flap, pedicled on the transverse branch of the lateral circumflex femoral artery, is a viable reconstructive option.
• This flap can be utilized by reconstructive and orthopedic surgeons for soft-tissue defects around the hip.
• The technique allows for defect repair without significant damage to the knee's functional apparatus.