Treatment of Greater Trochanteric Sore by using Distal Folded Tensor Fascia Lata Myocutaneous Flap

ABSTRACT

Tensor fascia lata myocutaneous flap is the most useful local flap in surgical treatment of greater trochanteric sore. But the small volume of muscle included in Tensor fascia lata myocutaneous flap makes the thickness of flap thinner and the rate of recurrence higher than any other muscle flap. To overcome this disadvantage, Scheflan(1981) used distal folded Tensor fascia lata myocutaneous flap in treating greater trochanteric sore. But Scheflan used this flap as an island flap, that made the blood supply unstable and unreliable, and required skillful technique. And he didn`t use distal part of the thigh which made the efficacy of flap bulk small. In order to thicken the flap bulk, we used the distal folded tensor fascia lata myocutaneous flap. We have treated 10 patients by using newly designed distal folded tensor fascia lata myocutaneous flap. All of them had previous systemic disease. Some had general paresthesia and others had heart failure, diabetic mellitus, neuralgia and so on. We drew V-shaped design, one wing was from the anterior superior iliac spine to the lateral condyle of the femur and the other wing was from the center of the greater trochanter to the lateral condyle of the femur. After design, we harvest the flap and fold the flap two or three times. Flap bulk is enough to prevent sore recurrence. We follow up the patients from 6 months to 35 months. No recurrence is occurred. Our newly designed flap has sufficient volume and reliable blood supply. The result is good and satisfactory.