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Biceps Femoris Musculocutaneous Flap for Reconstruction of Refractory Ulceration at the Popliteal Fossa

BACKGROUND: There is a lack of information about the possibility of transfer of the long head of the biceps femoris (LHBF) musculocutaneous flap to the knee area. We discuss the use of the LHBF musculocutaneous flap to treat refractory ulceration at the popliteal fossa and the results of a prelimina...

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Detalles Bibliográficos
Autores principales: Onishi, Tadanobu, Omokawa, Shohei, Shimizu, Takamasa, Sananpanich, Kanit, Tanaka, Yasuhito, Kira, Tsutomu, Murata, Keiichi, Honoki, Kanya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236384/
https://www.ncbi.nlm.nih.gov/pubmed/25426356
http://dx.doi.org/10.1097/GOX.0000000000000204
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author Onishi, Tadanobu
Omokawa, Shohei
Shimizu, Takamasa
Sananpanich, Kanit
Tanaka, Yasuhito
Kira, Tsutomu
Murata, Keiichi
Honoki, Kanya
author_facet Onishi, Tadanobu
Omokawa, Shohei
Shimizu, Takamasa
Sananpanich, Kanit
Tanaka, Yasuhito
Kira, Tsutomu
Murata, Keiichi
Honoki, Kanya
author_sort Onishi, Tadanobu
collection PubMed
description BACKGROUND: There is a lack of information about the possibility of transfer of the long head of the biceps femoris (LHBF) musculocutaneous flap to the knee area. We discuss the use of the LHBF musculocutaneous flap to treat refractory ulceration at the popliteal fossa and the results of a preliminary study investigating the anatomical possibility of transferring this flap to the popliteal region. METHODS: Five lower extremities of 5 fresh cadaveric specimens were dissected following injection of a silicone compound into the deep femoral artery. We investigated the number, location, and diameter of nutrient branches to the LHBF originating from the deep femoral artery. Based on these results, we treated a 76-year-old woman with a refractory postradiation ulcer at the popliteal fossa associated with popliteal artery obstruction using a 25 × 7 cm LHBF musculocutaneous flap. RESULTS: The mean number of nutrient branches to the LHBF muscle was 3.6, with a mean diameter of 1.9 mm. One to two branches consistently arose from the distal aspect of the posterior thigh. Most branches followed an intramuscular route, giving rise to fine cutaneous branches. The distal border reached by the musculocutaneous flap was located 6.7 cm distal to the bicondylar line. The flap survived completely without complications, and the patient was able to walk with a walking frame postoperatively. CONCLUSIONS: The LHBF musculocutaneous flap may offer a reliable treatment option for soft-tissue defects of the popliteal fossa, especially in patients with significant damage to the popliteal artery from trauma or radiation therapy.
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spelling pubmed-42363842014-11-25 Biceps Femoris Musculocutaneous Flap for Reconstruction of Refractory Ulceration at the Popliteal Fossa Onishi, Tadanobu Omokawa, Shohei Shimizu, Takamasa Sananpanich, Kanit Tanaka, Yasuhito Kira, Tsutomu Murata, Keiichi Honoki, Kanya Plast Reconstr Surg Glob Open Special Topic BACKGROUND: There is a lack of information about the possibility of transfer of the long head of the biceps femoris (LHBF) musculocutaneous flap to the knee area. We discuss the use of the LHBF musculocutaneous flap to treat refractory ulceration at the popliteal fossa and the results of a preliminary study investigating the anatomical possibility of transferring this flap to the popliteal region. METHODS: Five lower extremities of 5 fresh cadaveric specimens were dissected following injection of a silicone compound into the deep femoral artery. We investigated the number, location, and diameter of nutrient branches to the LHBF originating from the deep femoral artery. Based on these results, we treated a 76-year-old woman with a refractory postradiation ulcer at the popliteal fossa associated with popliteal artery obstruction using a 25 × 7 cm LHBF musculocutaneous flap. RESULTS: The mean number of nutrient branches to the LHBF muscle was 3.6, with a mean diameter of 1.9 mm. One to two branches consistently arose from the distal aspect of the posterior thigh. Most branches followed an intramuscular route, giving rise to fine cutaneous branches. The distal border reached by the musculocutaneous flap was located 6.7 cm distal to the bicondylar line. The flap survived completely without complications, and the patient was able to walk with a walking frame postoperatively. CONCLUSIONS: The LHBF musculocutaneous flap may offer a reliable treatment option for soft-tissue defects of the popliteal fossa, especially in patients with significant damage to the popliteal artery from trauma or radiation therapy. Wolters Kluwer Health 2014-11-07 /pmc/articles/PMC4236384/ /pubmed/25426356 http://dx.doi.org/10.1097/GOX.0000000000000204 Text en Copyright © 2014 The Authors. Published by Lippincott Williams & Wilkins on behalf of The American Society of Plastic Surgeons. PRS Global Open is a publication of the American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle Special Topic
Onishi, Tadanobu
Omokawa, Shohei
Shimizu, Takamasa
Sananpanich, Kanit
Tanaka, Yasuhito
Kira, Tsutomu
Murata, Keiichi
Honoki, Kanya
Biceps Femoris Musculocutaneous Flap for Reconstruction of Refractory Ulceration at the Popliteal Fossa
title Biceps Femoris Musculocutaneous Flap for Reconstruction of Refractory Ulceration at the Popliteal Fossa
title_full Biceps Femoris Musculocutaneous Flap for Reconstruction of Refractory Ulceration at the Popliteal Fossa
title_fullStr Biceps Femoris Musculocutaneous Flap for Reconstruction of Refractory Ulceration at the Popliteal Fossa
title_full_unstemmed Biceps Femoris Musculocutaneous Flap for Reconstruction of Refractory Ulceration at the Popliteal Fossa
title_short Biceps Femoris Musculocutaneous Flap for Reconstruction of Refractory Ulceration at the Popliteal Fossa
title_sort biceps femoris musculocutaneous flap for reconstruction of refractory ulceration at the popliteal fossa
topic Special Topic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236384/
https://www.ncbi.nlm.nih.gov/pubmed/25426356
http://dx.doi.org/10.1097/GOX.0000000000000204
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