Utilização de retalho baseado na artéria genicular lateral superior na cobertura de lesões de membros inferiores: relato de casos / Use of a flap based on the superior lateral genicular artery to cover lower limb injuries: case reports

O joelho é uma das principais articulações do corpo humano e, em função de sua conformação e funcionalidade, é facilmente suscetível a lesões. A reconstrução cirúrgica de lesões ao redor do joelho e região proximal da perna representa um grande desafio devido à exposição de estruturas osteoarticulares, tendinomusculares e neurovasculares e tem sido realizada com uso de diversos retalhos musculares e musculocutâneos. Outros retalhos também são descritos para tratamento dessas lesões, embora em menor frequência na literatura, como o retalho cutâneo baseado no pedículo da artéria genicular lateral superior. A seguir, é apresentado o relato de cinco casos de pacientes vítimas de acidentes motociclísticos nos quais realizou-se a cobertura da lesão ao redor do joelho e região proximal da perna com o uso do retalho cutâneo baseado no pedículo da artéria genicular lateral superior, nos quais foram obtidos uma boa cobertura das lesões, alta taxa de sobrevida do retalho, bons resultados clínicos e estéticos. O uso do artéria genicular lateral superior apresenta vantagens estéticas, visto que a cor e a textura do retalho são semelhantes às da região do joelho e conferem uma aparência de melhor qualidade, além de não causarem problemas de mobilidade articular.

The knee is one of the main joints in the human body, and due to its conformation and functionality, it is easily susceptible to injuries. Surgical reconstruction of injuries around the knee and proximal region of the leg represents a major challenge due to the exposure of osteoarticular, tendinomuscular and neurovascular structures and has been performed using various muscle and musculocutaneous flaps. Other flaps are also described for treating these lesions, although less frequently in the literature, such as the cutaneous flap based on the pedicle of the superior lateral genicular artery. Next, It presents a report of five cases of patients who were victims of motorcycle accidents in which the lesion was covered around the knee and proximal region of the leg using a skin flap based on the pedicle of the superior lateral genicular artery, in which good coverage of lesions, high flap survival rate, good clinical and aesthetic results. The use of the superior lateral genicular artery presents aesthetic advantages since the color and texture of the flap are similar to those of the knee region and provide a better quality appearance, in addition to not causing joint mobility problems.

Case Report: Myocardial Bypass in Left Descending Artery - A Rare Congenital Anomaly

Abstract Myocardial bypass (MB) is known to have scientific relevance and is present in several studies with great statistical significance regarding its clinical manifestations and complications. There are still questions about MB in its relationship with heart disease and repercussion in life-threatening conditions. We present a case report of a MB in the left anterior descending coronary artery, whose objective is to identify this rare congenital anomaly and to highlight the patient's clinical outcome in order to elicit greater contributions about the presence of this variant in the emergency room, its diagnosis by angiography and therapeutic management.