Vastus lateralis flap for trochanteric sarcoma reconstruction following prior main pedicle dissection: A case report

Fadel,Zahir T.; Basaeed,Amani J.; Ashi,Mohammed B.; Aljaaly,Hattan A.

doi:10.3892/etm.2024.12537

Vastus lateralis flap for trochanteric sarcoma reconstruction following prior main pedicle dissection: A case report

Authors:
- Zahir T. Fadel
- Amani J. Basaeed
- Mohammed B. Ashi
- Hattan A. Aljaaly
View Affiliations

Affiliations: Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Kingdom of Saudi Arabia, Department of Plastic and Reconstructive Surgery, National Guard Hospital, Jeddah 21423, Kingdom of Saudi Arabia
Published online on: April 12, 2024 https://doi.org/10.3892/etm.2024.12537
Article Number: 249
Copyright: © Fadel et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The reconstruction of trochanteric defects presents a challenge to the reconstructive surgeon. There have been a number of locoregional reconstructive options described in the literature. These include flaps based on the lateral circumflex femoral artery and its branches, such as the tensor fascia lata, vastus lateralis (VL), anterolateral thigh (ALT) flaps. The present case further complicated this challenge as the patient had multiple recurrences of a sarcoma overlying the trochanteric region, with previous surgical resections, reconstruction and radiotherapy. The present case study describes an approach to harvesting the VL flap in a patient with previously harvested ALT.

View Figures

View References

1	Haque SA, Georgiou A and Woollard A: Pedicled ipsilateral anterolateral thigh (ALT) with flow-through to a secondary contralateral-free ALT flap for coverage of large thigh, trochanteric and gluteal area defects: A case report. Microsurgery. 41:276–279. 2021.PubMed/NCBI View Article : Google Scholar
2	Hohenberger P and Schwarzbach MH: Management of locally recurrent soft tissue sarcoma after prior surgery and radiation therapy. Recent Results Cancer Res. 179:271–283. 2009.PubMed/NCBI View Article : Google Scholar
3	Mulholland S, Boyd JB, McCabe S, Gullane P, Rotstein L, Brown D and Yoo J: Recipient vessels in head and neck microsurgery: Radiation effect and vessel access. Plast Reconstr Surg. 92:628–632. 1993.PubMed/NCBI View Article : Google Scholar
4	Ballo MT, Zagars GK, Pollock RE, Benjamin RS, Feig BW, Cormier JN, Hunt KK, Patel SR, Trent JC, Beddar S and Pisters PW: Retroperitoneal soft tissue sarcoma: An analysis of radiation and surgical treatment. Int J Radiat Oncol Biol Phys. 67:158–163. 2007.PubMed/NCBI View Article : Google Scholar
5	Minami RT, Hentz VR and Vistnes LM: Use of vastus lateralis muscle flap for repair of trochanteric pressure sores. PIast Reconstr Surg. 60:364–368. 1977.PubMed/NCBI
6	Bovet JL, Nassif TM, Guimberteau JC and Baudet J: The vastus lateralis musculocutaneous flap in the repair of trochanteric pressure sores: Technique and indications. PIast Reconstr Surg. 69:830–834. 1982.PubMed/NCBI View Article : Google Scholar
7	Mathes SJ and Nahai F: Classification of the vascular anatomy of muscles: Experimental and clinical correlation. Plast Reconstr Surg. 67:177–187. 1981.PubMed/NCBI
8	Wong CH and Wei FC: Anterolateral thigh flap. Head Neck. 32:529–540. 2010.PubMed/NCBI View Article : Google Scholar
9	Wong CH, Ong YS and Wei FC: Revisiting vascular supply of the rectus femoris and its relevance in the harvest of the anterolateral thigh flap. Ann Plast Surg. 71:586–590. 2013.PubMed/NCBI View Article : Google Scholar
10	Wei FC, Jain V, Celik N, Chen HC, Chuang DC and Lin CH: Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg. 109:2219–2226; discussion 2227-30. 2002.PubMed/NCBI View Article : Google Scholar
11	Mathes SJ and Nahai F: Reconstructive surgery: Principles, Anatomy and Technique 2-Volume Set. Vol 2. 1st edition. Churchill Livingstone, London. pp1233-1246, 1997.
12	Toia F, D'Arpa S, Brenner E, Melloni C, Moschella F and Cordova A: Segmental anatomy of the vastus lateralis: Guidelines for muscle-sparing flap harvest. Plast Reconstr Surg. 135:185e–98e. 2015.PubMed/NCBI View Article : Google Scholar
13	Vanni S, De Vita A, Gurrieri L, Fausti V, Miserocchi G, Spadazzi C, Liverani C, Cocchi C, Calabrese C, Bongiovanni A, et al: Myxofibrosarcoma landscape: Diagnostic pitfalls, clinical management and future perspectives. Ther Adv Med Oncol. 14(17588359221093973)2022.PubMed/NCBI View Article : Google Scholar
14	Rodaix C, Auregan JC, Lhuaire M, Feydy A, Soubeyrand M and Biau D: The proximal vastus lateralis flap: An anatomical and radiological study. Morphologie. 106:75–79. 2022.PubMed/NCBI View Article : Google Scholar
15	Stranix JT, Lee ZH, Lam G, Mirrer J, Rapp T and Saadeh PB: Limb-sparing sarcoma reconstruction with functional composite thigh flaps. Microsurgery. 38:466–472. 2018.PubMed/NCBI View Article : Google Scholar
16	Kim J, Lee H, Pyon JK, Mun GH, Bang SI, Jeon BJ and Lee KT: Association of unilateral latissimus dorsi muscle harvest for breast reconstruction with postoperative spinal posture. Plast Reconstr Surg. 150:644e–654e. 2022.PubMed/NCBI View Article : Google Scholar
17	Oberhofer HM, Samant SS, Swan CC, Wolfe EM, Satteson ES, Leyngold MM and Chim H: Objective comparison of donor-site morbidity following full and thoracodorsal nerve-preserving split latissimus dorsi flaps. Plast Reconstr Surg. 149:966e–971e. 2022.PubMed/NCBI View Article : Google Scholar
18	Zhang R, Sun J, Wei X, Zhang H, Liu Y, Shi M and Shi Y: Reconstruction of defects with the posterior femoral fasciocutaneous flap after resection of malignant tumours of the femoral greater trochanter, sacrococcygeal region and knee. J Plast Reconstr Aesthet Surg. 62:221–229. 2009.PubMed/NCBI View Article : Google Scholar
19	Nisanci M, Sahin I, Eski M and Alhan D: A new flap alternative for trochanteric pressure sore coverage: Distal gluteus maximus musculocutaneous advancement flap. Ann Plast Surg. 74:214–219. 2015.PubMed/NCBI View Article : Google Scholar