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Volume 39 Issue 7
Jul.  2023
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(7): 648-654
He XQ,Yang X,Shi Y,et al.Clinical effects of retrograde anterolateral thigh flaps in repairing anterior knee joint wounds under the concept of precise flap surgery[J].Chin J Burns Wounds,2023,39(7):648-654.DOI: 10.3760/cma.j.cn501225-20221020-00461.
Citation: He XQ,Yang X,Shi Y,et al.Clinical effects of retrograde anterolateral thigh flaps in repairing anterior knee joint wounds under the concept of precise flap surgery[J].Chin J Burns Wounds,2023,39(7):648-654.DOI: 10.3760/cma.j.cn501225-20221020-00461.
shu

Clinical effects of retrograde anterolateral thigh flaps in repairing anterior knee joint wounds under the concept of precise flap surgery

doi: 10.3760/cma.j.cn501225-20221020-00461
  • 1.

    Department of Orthopedic Surgery, the 920th Hospital of Joint Logistic Support Force of PLA, Kunming 650032, China

  • 2.

    Department of Emergency Surgery, the Second People's Hospital of Yunnan Province, Kunming 650021, China

  • 3.

    Department of Orthopedic Surgery, the First People's Hospital of Yunnan Province, Kunming 650034, China

Funds:

Yunnan Provincial Clinical Orthopaedic Trauma Medical Center ZX2019-10-01

Yunnan Orthopedics and Sports Rehabilitation Clinical Medicine Research Center 202102AA310068

Science and Technology Planning Program of Yunnan Province Science and Technology Department 202101AY070001-298, 202201AY070001-288, 202201AY70001-292

In-hospital Science and Technology Program of the 920th Hospital of Joint Logistic Support Force of PLA 2019YGB05, 2020YGD08, 2020YGC02

More Information
  • Corresponding author: Su Yongyue, Email: drsuyy@qq.com
  • Received Date: 2022-10-20
    Abstract
  •   Objective   To introduce the methods of retrograde anterolateral thigh flaps in repairing anterior knee joint wounds under the concept of precise flap surgery and to explore the clinical effects.   Methods   A retrospective observational study was conducted. From August 2014 to March 2022, 7 patients with anterior knee joint wounds were treated with retrograde anterolateral thigh flap under the guidance of the concept of precise flap surgery in the 920 th Hospital of Joint Logistic Support Force of PLA. Among them, 6 were males and 1 was female, aged 36 to 66 years. The sizes of wounds were 7 cm×5 cm to 15 cm×11 cm after debridement. All the patients were performed with computed tomography angiography (CTA), the donor and recipient sites were evaluated according to the precise flap surgery method, and the optimal pedicle, perforator, and pivot of flaps were chosen. The flap sizes were 10 cm×6 cm to 20 cm×9 cm, and all the donor sites of flaps were sutured directly. The consistency of the intraoperative exploration with preoperative CTA was observed. The flap survival and occurrence of complications were observed after surgery. The color, appearance, texture, and occurrence of complications were followed up. At the last follow-up, the blood supply of flaps was evaluated using the blood circulation evaluation indicators of Chinese Medical Association Hand Surgery Branch's trial criteria for digital replantation function evaluation, and the function of knee joint was evaluated using knee joint scoring system of hospital for special surgery.   Results   The flap condition of the intraoperative exploration was completely consistent with that of preoperative CTA. The flaps survived completely after surgery in 6 patients, while necrosis at the edge of the flap occurred in 1 patient, which healed after dressing change. All the flaps were hyperperfused after surgery, and the color of the flaps gradually became normal after 1 week. Follow-up of 7 to 44 months showed that the color, appearance, and texture were well in all the patients, while local osteomyelitis at the proximal tibia occurred in 1 patient. At the last follow-up, all the 7 patients had excellent blood circulation; the function score of knee joint was 69 to 91, which was evaluated as excellent in 3 cases, good in 3 cases, and fair in 1 case.   Conclusions   The retrograde anterolateral thigh flap has large variations, and the application of precise flap surgery method can accurately understand the variations before surgery, guide the design and cutting of the flaps, thus achieving precise repair of anterior knee joint wounds, with good repair outcome.

     

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