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Published on: January 11, 2016
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Medial-Based Myofasciocutaneous Flap Above Knee Amputation
Wei Wei Wu1, Christopher Finkemeier
1Orthopaedic Trauma Surgeons of Northern California, Carmichael, CA.
Journal of Orthopaedic Trauma
|September 11, 2025
Summary
A 62-year-old man with peripheral vascular disease underwent an above-knee amputation for a severe leg infection. A medial-based myofasciocutaneous flap, utilizing the obturator artery, was employed for reconstruction.
Area of Science:
- Vascular Surgery
- Reconstructive Surgery
- Infectious Disease
Background:
- Peripheral vascular disease (PVD) can lead to chronic, nonhealing ulcers.
- Deep infection of lower extremity ulcers poses significant systemic risks.
- Reconstruction following amputation requires careful consideration of vascular supply.
Purpose of the Study:
- To describe a case of severe lower extremity infection in a patient with PVD.
- To detail the surgical technique for above-knee amputation and flap reconstruction.
- To highlight the use of a medial-based myofasciocutaneous flap for limb salvage.
Main Methods:
- Above-knee amputation performed for a nonhealing, infected ulcer.
- Medial-based myofasciocutaneous flap designed based on obturator artery vascularity.
- Anatomic dissection and myodesis technique detailed.
Main Results:
- Successful limb salvage and reconstruction achieved.
- Flap survival demonstrated, supported by the obturator artery's vascularity.
- The surgical technique proved methodical and reproducible.
Conclusions:
- A medial-based myofasciocutaneous flap is a viable option for reconstruction after amputation in PVD patients.
- Utilizing the obturator artery provides a reliable vascular source for the flap.
- The described surgical technique offers a reproducible approach for surgeons.
