Purposes
The current study aimed to focus on the versatility of the superiorly based pedicled
gastrocnemius muscle fl ap or myocutaneous fl ap, either medial or lateral head, in upper-leg
defects after trauma or tumor excision and the importance of these fl aps to improve bone
healing in trauma and to ensure an adequate safety margin in malignant tumors with minimal
complications.
Patients and methods
A prospective, randomized trial was conducted on 27 patients suffering from upper-leg defects
after trauma or tumor excision to compare postoperative outcomes, especially bone healing,
using superiorly based pedicled gastrocnemius muscle fl ap covered by a split thierch skin graft
[group A; 14 (51.8%)] against myocutaneous fl ap [group B, 13 (48.2%) cases], either medial
or lateral head. Postoperative follow-up was for 6 months.
Results
Rapid healing of the tibial fracture was noticed in 8 (57.1%) cases in group A and in 8 (61.5%)
cases in group B within 2 weeks after surgery, and there was no fl ap loss apart from partial skin
loss, minor hematomas, or infections, all were noticed signifi cantly more in group A [5 (35.7%),
6 (42.9%), and 4 (28.6%) cases, respectively], compared with group B [1 (8%), 2 (15.4%), and
1 (8%) cases, respectively; P < 0.05].
Conclusion
Both gastrocnemius myocutaneous and myocutaneous fl aps for upper-leg reconstruction are
considered as a reliable option to ensure a good safety margin in malignant tumor cases and
to help bone healing in trauma cases, and myocutaneous fl aps are safer, with no redo and
lesser postoperative complications |
