A muscle-sparing technique for reconstruction of the defect left after excisional hip arthroplasty.

Muscle flap closure is the treatment of choice for coverage of the failed hip arthroplasty defect. Several described muscle flaps work well, but they sacrifice functioning parts of the abdominal wall or quadriceps femoris mechanisms. The authors describe the use of the tensor fascia lata musculocutaneous flap for this purpose. The technique described has been previously used successfully to reconstruct over 100 trochanteric pressure sores. This flap spares more important muscles, requires no skin graft, and exposes the deep wound well for debridement.

The fasciocutaneous flap: a conservative approach to the exposed knee joint.

The exposed knee joint poses a challenge to the reconstructive surgeon. The currently popular approach to the repair of exposed knee joints is use of muscle flaps. However, this leaves the patient with a deficit. We have therefore begun using the fasciocutaneous flap as an initial approach to this problem. In seven patients, aged 28 to 74 years, fasciocutaneous flaps have been the reconstructive procedure of choice for repair of exposed knee joints. One patient with a very large open wound required a concomitant medial gastrocnemius muscle flap. One minor wound separation occurred in a paraplegic patient with severe spasm. No other complications occurred. Follow-up ranged from 3 to 12 months, with good success in wound closure. An approach to small and intermediate wounds is presented in which the V-Y technique is used to obviate the need for skin grafting of the donor site.