Vastus Medialis Myocutaneous and Myocutaneous-Tendinous Composite Flaps
Vastus Medialis Myocutaneous and Myocutaneous-Tendinous Composite Flaps
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股内侧肌皮瓣和肌皮腱复合皮瓣
DOI：
10.1097/00006534-198505000-00010
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发表时间：
1985
影响因子：
3.6
通讯作者：
G. Tobin
中科院分区：
文献类型：
--
作者：
G. Tobin
本报告描述了一个新的肌皮区域，并介绍了一种基于股内侧肌的新肌皮瓣。对 32 条新鲜尸体腿进行解剖、动脉染料灌注和标本血管造影，确定了直接覆盖肌肉的股内侧肌皮肤区域，并确定了由肌肉血管化的股四头肌肌腱片段。该血管单元提供了用于闭合膝关节前部缺损的肌皮瓣。该皮瓣还可以通过包含血管化的股四头肌腱段设计为复合肌皮腱瓣，从而可以重建缺失的髌腱段。保留运动神经支配的远端推进皮瓣设计保留了股内侧肌对膝关节伸展的贡献。股内侧肌皮瓣和肌皮腱皮瓣在三名膝关节缺损和髌腱缺失患者中的应用说明了其临床应用。讨论了血管化肌腱（与血管游离肌腱移植物相比）对于髌腱重建的潜在价值。
This report describes a new myocutaneous territory and introduces a new myocutaneous flap based on the vastus medialis muscle. Dissection, arterial dye perfusion, and specimen angiography of 32 fresh cadaver legs defined a vastus medialis myocutaneous territory directly overlying the muscle and also defined a segment of quadriceps femoris tendon vascularized by the muscle. This vascular unit provides a myocutaneous flap for closure of anterior knee defects. This flap can also be designed as a composite myocutaneous-tendinous flap by inclusion of the vascularized quadriceps femoris tendon segment, which allows reconstruction of missing patellar tendon segments. The distal advancement flap design with retention of motor innervation preserves vastus medialis contribution to knee extension. Clinical applications of vastus medialis myocutaneous and myocutaneous-tendinous flaps are illustrated by their use in three patients with knee defects and patellar tendon losses. The potential value of vascularized tendon (versus vascular free tendon grafts) for patellar tendon reconstruction is discussed.