抄録
We report the utility of the distally based sartorius muscle flap for the soft tissue defect after total knee arthroplasty (TKA).
A 67-year-old woman underwent osteosynthesis with a condylar plate due to a supracondylar fracture of the right femur in 1999. Four years later, TKA with the V-Y plasty of the quadriceps muscle was performed, because the severe contracture (0-40 degrees) and osteoarthrosis had developed. Several days after the surgery, necrosis of the skin and subcutaneous tissue in the supracondylar area occurred, and the sutured quadriceps muscle separated. This skin and muscle defect exposed the femoral component. A month later, we performed the sartorius muscle flap graft with a free skin graft. Although bacteria containing gram-positive rods had been cultured, we preserved the prosthesis by intensive irrigation. The sartorius muscle was detached near its origin, and folded at the distal third of the muscle belly. The muscle flap was covered with a thin skin graft from the inguinal region. Six months later, the femoral component was completely covered with the grafted tissue, and there was no recurrence of infection. Plain x-ray images showed no evidence of loosening, and she could walk without pain using a soft knee brace.
The distally based sartorius muscle flap is useful for coverage of the supracondylar area of the knee joint, because it can easily provide muscle bulk with a reliable vascular supply.
