Use of the Vastus Lateralis Muscle Flap With a Grooving Procedure in the Surgical Treatment of Chronic Osteomyelitis of the Femur
Makaleler > Tam Makale · 2004
Yazarlar: Serdar Necmioglu, Ibrahim Askar, Veli L??k, Mehmet Subasi
Annals of Plastic Surgery, Uluslararası, Wos, 2004, cilt 53, ss 570-576
DOI: 10.1097/01.sap.0000134752.01294.d0
Özet
In Brief Severe femoral fractures may be associated with devascularization of cortical bone, soft-tissue loss, and significant morbidity. After surgical treatment of these femoral fractures, chronic infection may ensue and requires additional reconstructive procedures. Local muscle flap coverage is used to treat chronic osteomyelitis. A new procedure—the vastus lateralis muscle flap with grooving of the femoral shaft—was used for the treatment of chronic osteomyelitis of the femoral shaft. The authors present 6 patients with chronic osteomyelitis of the femur who were treated with a vastus lateralis muscle flap. Five of the patients were male and the other was female. The average age of the patients was 33.8 years (range, 17–54 years). All patients experienced infection during the early postoperative period. Drainage of abscess, debridement, sequestrectomy repair of fistula, and mini fenestration were performed at least 3 times, and antibiotics were administered several times. During the operations, tissue samples were evaluated for bacterial cultivation. Staphylococcus aureus was seen in 4 patients, S. epidermidis in 1 patient, and Pseudomonas aeruginosa in the remaining patient. A vastus lateralis muscle flap with grooving of the infected femoral shaft is presented. The authors have not encountered a recurrence of infection during a minimum 3.9 years of follow-up. They think this technique is an alternative to the current techniques for the surgical treatment of chronic osteomyelitis of the femur. Six patients with chronic post-fracture osteomyelitis of the femur were successfully treated with creation of a 1.4-cm groove along the infected femoral shaft, curettage of the medullary canal, and drilling of a series of holes in the back wall 1.5 - 2.0 cm apart. The vastus lateralis muscle was transferred to the groove and sutured through the holes.