Adductor myocutaneous flap coverage for hip and pelvic disarticulations of sarcomas with buttock contamination.

Clinical Orthopaedics and Related Research
Michael L Marfori, Edward H M Wang

Abstract

Hip disarticulation and hemipelvectomy are alternatives to limb-salvage procedures for patients with extensive tumors of the upper thigh and buttocks. In cases when neither the conventional posterior gluteus maximus flap nor the anterior quadriceps flap can be used because of the location of the tumor, a medial adductor myocutaneous flap may be an alternative. The flap is outlined over the anteromedial thigh. The distal extent is at the level of the adductor hiatus. The common femoral vessels and nerve are traced, preserved, and protected. The adductor muscles then are divided above their insertions on the femur and preserved with the flap. En bloc removal of the tumor is performed by either hip disarticulation or hemipelvectomy. The long adductor myocutaneous flap is brought up laterally and proximally to close the wound. We reviewed four patients who underwent a medial adductor myocutaneous flap after either hip disarticulation or hemipelvectomy. The medical records and radiographs were analyzed. These patients were followed up for at least a year or until death. Wide surgical margins were achieved in all four patients and the flap remained viable, with no skin necrosis or flap breakdown. The patients were able to sit on the ...Continue Reading

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Citations

Apr 29, 2014·Journal of Neurosurgery. Spine·Konstantinos A StarantzisPanayiotis J Papagelopoulos
Feb 9, 2012·Orthopedics·Andreas F MavrogenisPanayiotis J Papagelopoulos
Mar 4, 2020·Journal of Orthopaedic Surgery·Alireza K NazemiFazel A Khan
Dec 5, 2019·Journal of Medical Case Reports·Ayako KamitomoYoshie Sasaki
Jul 30, 2011·Surgical Oncology·Andreas F MavrogenisPanayiotis J Papagelopoulos

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