Stefano Fracon
PORPOSE: Reconstruction of the anatomical area of the knee is challenging due to its intrinsic needs in terms of vascularization, reliability an pliability of the covering tissues. In a difficult setting where the classic workhorses flaps have failed to cover the defect a new approach is needed to overcome the limits of well known salvage procedures.
CASE PRESENTATION: A 16 years old girl underwent surgery for a tibial head osteosarcoma. Classical local flaps failed to cover the defect in other institutions due to different problems and the the prothesis was substituted by antibiotic-loaded bone cement. The defect measured 5x4 cm. The amputation was avoided by using the vastsus intermedius flap.
DISCUSSION: At 5-day post-op, neither necrosis of the flap nor dehiscence of the wound was detected. After two months the definitive prothesis was inserted. At two-years follow up the flap tissue is soft and pliable, the coverage is optimal and the patient can walk without crutches. In a difficult setting the vastus intermedius flap is reliable solution useful to spare the few remaining vessels of the area for a future salvage procedure. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with Ethical Standards
Conflict of Interest: The authors declare not to have any conflict of interest. Informed consent was obtained from the individual included in the report.