ALT flap with vascularized fascia lata for one-stage functional patellar tendon reconstruction.

Détails

ID Serval
serval:BIB_75CEE363B707
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
ALT flap with vascularized fascia lata for one-stage functional patellar tendon reconstruction.
Périodique
Journal of plastic, reconstructive & aesthetic surgery
Auteur(s)
Sapino G., Zaugg P., Cherix S., Borens O., Lo S.J., Raffoul W., di Summa P.G.
ISSN
1878-0539 (Electronic)
ISSN-L
1748-6815
Statut éditorial
Publié
Date de publication
03/2019
Peer-reviewed
Oui
Volume
72
Numéro
3
Pages
467-476
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Composite anterolateral thigh (ALT) flap with vascularized fascia lata can reconstitute patellar tendon integrity and knee soft tissue coverage in one stage. However, long-term evidence of outcomes is lacking. This work analyzes long-term functional results, compares subtotal and total reconstruction of patellar tendon, and assesses the respective function of the extensor apparatus.
Outcomes of reconstruction using 10 ALT flaps in 9 patients (age range 21-87 years) were analyzed (mean follow-up 30 ± 6 months). Knee Society Scores, isometric knee extensor strength (M1-M5), and sensory recovery were evaluated, together with active range of motion and extensor lag of the reconstructed limb, compared to contralateral.
Ten flaps were used for tendon replacement in 9 patients. Eight (80%) free flaps and 2 (20%) propeller distally based flaps were used. Complications requiring the harvest of a second flap were seen in 2 patients. All patients could return to their daily activities without the use of walking supports. Mean active ROM was 94.4° with an extensor lag of 9.4°, without a significant difference between partial and total patellar tendon reconstruction. The mean knee and functional scores of the Knee Society were 81/100 and 77/100, respectively.
Composite ALT flap with fascia lata can satisfy the twofold needs of functional restoration and soft tissue coverage, thus ensuring stable results in total and subtotal knee extensor mechanism reconstruction. Distally based flaps should be carefully considered, as they lead to higher complication rates.
Mots-clé
ALT flap, Patellar tendon reconstruction, Vascularized fascia lata
Pubmed
Web of science
Création de la notice
05/01/2019 15:19
Dernière modification de la notice
20/08/2019 14:33
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