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J Reconstr Microsurg 2006; 22(1): 025-032
DOI: 10.1055/s-2006-931903
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Devastating Massive Knee Defect Reconstruction Using the Cornucopian Chimera Flap from the Subscapular Axis: Two Case Reports

Kazufumi Sano1 , Geoffrey G. Hallock2 , Satoru Ozeki3 , Hirohiko Suzuki4 , Reiko Mawatari4 , Keishiro Yoshino4 , Masahiro Hamazaki4
  • 1Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital, Tokyo, Japan
  • 2Division of Plastic Surgery, The Lehigh Valley Hospitals, Allentown, PA
  • 3Dokkyo University Koshigaya Hospital, Koshigaya, Japan
  • 4Division of Orthopedic surgery, Kenwakai Otemachi Hospital, Fukuoka, Japan
Further Information

Publication History

Accepted: September 20, 2005

Publication Date:
19 January 2006 (online)

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ABSTRACT

Two cases of successful reconstruction of massive defects around the knee with multiple-island combined flaps based on the subscapular axis are reported. Both defects resulted from aggressive debridement for acute osteomyelitis after open fixation of high-energy fractures around the knee. In Case 1, a four-island combined flap consisting of the scapular flap, the lattissimus dorsi muscle flap, the serratus anterior muscle flap, and the scapular osseous flap, based on the same subscapular axis, was used. Partial bone transport using the Ilizarov apparatus was added as reinforcement of arthrodesis. In Case 2, a five-island combined flap, consisting of the scapular, parascapular flap, the lattissimus dorsi muscle flap, the serratus anterior fascial flap, and the scapular osseous flap, was used. Consequent ankylosis of the knee joint afforded the patient painless full weight bearing without secondary arthrodesis. Multiple-island combined flaps based on the subscapular axis can provide three-dimensional reconstruction of destructive knee defects.

KEYWORDS

Subscapular axis - multiple-island flap - knee defect

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Kazufumi SanoM.D. 

Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital

1-1-5 Sendagi, Bunkyo-ku Tokyo, 113-8603, Japan