Repairing proximal and middle lower-leg wounds with retrograde sartorius myocutaneous flap pedicled by perforating branches of medial inferior genicular artery or posterior tibial artery

Yu-ming Shen, Dong-ning Yu, Xiao-hua Hu, Feng-jun Qin, Ming Li, Fang-gang Ning
Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS 2012, 65 (9): 1158-64

BACKGROUND AND OBJECTIVES: The blood supply of the lower one-third of the sartorius muscle is mainly provided by the descending genicular artery (saphenous artery). The terminal branches of the saphenous artery, together with the perforators of the posterior tibial artery and medial inferior genicular artery, form a stable and rich anastomotic network in the genus inferior medialis. Based on this anatomy, we designed a retrograde sartorius myocutaneous flap to repair wounds in the proximal and middle thirds of the lower leg.

METHODS: A sartorius myocutaneous flap with the posterior tibial (or medial inferior genicular) artery perforators as the pedicle was designed. The flap was based on a retrograde flow route: medial inferior genicular and posterior tibial artery perforators, the vascular network at the inferomedial knee, the saphenous artery, saphenous artery perforators, to the sartorius muscle. With this design, the flap can be transferred to the middle and proximal tibia. Between January 2007 and June 2010, 12 patients with middle/proximal lower-leg wounds were successfully treated with this method.

RESULTS: Ten of 12 myocutaneous flaps survived with primary healing of wounds. Two cases developed a small degree of distal superficial skin necrosis but with normal muscular blood supply and healed after conservative treatment.

CONCLUSION: Retrograde sartorius myocutaneous pedicle flaps from the perforating branches of the medial inferior genicular artery or posterior tibial artery have advantages in terms of reliable blood supply, ease of operation and minimal amount of damage, and can be used to repair proximal and middle lower-leg wounds. They are especially applicable when lower-leg flaps are unavailable due to poor soft-tissue conditions following trauma or multiple operations. However, the safety flap size needs to be determined in future studies.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"