Anatomy of the Vascularized Lateral Femoral Condyle Flap

Parvizi, Daryousch; Vasilyeva, Anna; Wurzer, Paul; Tuca, Alexandru; Lebo, Patricia Beatrice; Winter, Raimund; Clayton, Robert P.; Rappl, Thomas; Schintler, Michael; Kamolz, Lars‐Peter; Buerger, Heinz

doi:10.1097/prs.0000000000002182

Cited by 28 publications

(26 citation statements)

References 45 publications

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“…; Parvizi et al. ). Its diameter at origin measures 1.4–2.8 mm and the pedicle length is about 8 cm (Hayashi & Maruyama, ; Parvizi et al.…”

Section: Discussionmentioning

confidence: 98%

“…Its diameter at origin measures 1.4–2.8 mm and the pedicle length is about 8 cm (Hayashi & Maruyama, ; Parvizi et al. ). The SLGA subdivides into an anterior (also named superficial or patellar) and a posterior (also named deep or condylar) branch, and is responsible for the blood supply to the lateral femoral condyle, the lateral head of the gastrocnemius muscle, the vastus lateralis muscle and the biceps femoris muscle (Kirschner et al.…”

Section: Discussionmentioning

confidence: 99%

“…; Parvizi et al. ; Morsy et al. ), but data on the respective size of the perforator angiosomes are hitherto lacking.…”

Section: Introductionmentioning

confidence: 99%

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Vascular coverage of the anterior knee region – an anatomical study

2019

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Descriptions of vessel angiosomes or perforasomes throughout the human body are quite frequent, and led to the development of flaps nowadays commonly used to surgically cover skin and soft tissue defects. In these procedures, the surgeon requires a profound anatomical knowledge of the respective blood vessels and the extent of the perfused area to define the size of the graft. In the region of the knee joint, descriptions of flaps based on the superior lateral genicular artery and descending genicular artery are quite frequent. In contrast, information regarding other popliteal branches is scarce or non‐existent. The aim of this study was to provide a concise and complete overview on the extent and variability of the perforator angiosomes of the femoral and popliteal arteries in the anterior knee region. Twenty lower extremities were dissected, the respective perforators identified and perfused with dye. All resulting angiosomes were marked and documented. A total of 84 angiosomes were identified in all specimens, with an average of 4.2 (3–6) angiosomes per specimen. The average size of the angiosomes was 97.04 ± 72.30 cm 2 (8.61–360.41 cm 2 ), their source vessels had an average diameter of 1.42 ± 0.54 mm (0.60–3.25 mm). The complex and highly variable distribution of perforator angiosomes of the anterior knee region and especially of its less frequently investigated distal part was demonstrated. Based on these results, the planning of existing perforator flaps in this region and the development of flaps including the inferior medial or inferior lateral genicular arteries may be facilitated.

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“…; Parvizi et al. ). Its diameter at origin measures 1.4–2.8 mm and the pedicle length is about 8 cm (Hayashi & Maruyama, ; Parvizi et al.…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Vascular coverage of the anterior knee region – an anatomical study

2019

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“…Wong, Buerger, Iorio, and Higgins () investigated for the first time the vascular anatomy of the SLGA, focusing on the branches for the lateral condyle. Parvizi et al () described a branch for the ILTB originating from the superficial patellar branch of the SLGA and presented the first case of reconstruction of Achilles tendon with a vascularized ILTB flap. The SLGA is constant; however, this is not the case for its perforators (Parvizi et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Parvizi et al () described a branch for the ILTB originating from the superficial patellar branch of the SLGA and presented the first case of reconstruction of Achilles tendon with a vascularized ILTB flap. The SLGA is constant; however, this is not the case for its perforators (Parvizi et al, ). Given these anatomical variations, a Duplex sonographic investigation of the lower limb is mandatory in the preoperative workup.…”

Section: Discussionmentioning

confidence: 99%

The fasciocutaneous iliotibial band perforator flap in soft tissue and tendon reconstruction of the foot: A case report

et al. 2019

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In cases of large defects of the limbs, post‐traumatic deformity and disability can have devastating effects on patients' quality of life. The purpose of this report is to describe the technique for raising a fasciocutaneous iliotibial perforator flap and present its application in the reconstruction of a complex soft tissue defect of the foot. The patient was a 13‐year‐old male who had suffered a crush injury to the foot in a motor vehicle accident 5 years earlier. Due to retraction of the skin, together with the extensor tendons of the digits, the patient could not flex the digits II, III, IV, and V. To reconstruct the defect, the authors harvested a fasciocutaneous flap based on a perforator branch of the superior lateral genicular artery and accompanying veins. The immediate postoperative course was uneventful, with progressive and complete recovery of power and range of motion in the foot and knee within 6 weeks. Despite the tendency to form hypertrophic scars again, the functionality of the operated foot was excellent 29 months after the reconstruction. According to the American Orthopedic Foot and Ankle Society scale, the patient scored 100 points on the midfoot section and 93 points on the section forefoot rays two to five. The iliotibial perforator flap could be a new tool for a state‐of‐the‐art functional reconstruction of soft tissues defects of the limbs and head and neck.

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The condylar capping for microvascular temporomandibular joint reconstruction: A preliminary study

et al. 2022

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Background Defects of the temporomandibular joint (TMJ) are often difficult to be reconstructed in the correct dimensions and function. This preliminary study aims to describe a novel technique of condylar reconstruction with a microvascular flap in case of deforming arthrosis of the TMJ: condylar capping. Patients and Methods Four patients between 22 and 62 years old—three females and one male—with severe unilateral arthrosis of the TMJ underwent condylar capping. All patients had already had a failed conservative treatment, followed by arthroscopy with lysis and lavage and later open surgery with total or subtotal diskectomy combined with a condylar arthroplasty. Nevertheless, their pain was still at level six or more on a visual analogue scale. Moreover, they could eat only soft food. At this stage, they underwent condylar capping using an osteochondral lateral femoral condyle (LFC) flap. The surgical technique and the postoperative management are described in detail. Crucially the attachment of the lateral pterygoid muscle to the condylar neck was preserved in all cases. The patients were followed up clinically and by CT scan preoperatively, 6, and 12 months postoperatively. Results The mean height of the reconstructed neo‐condyle was 6.0 mm, the mean width 16.2 mm, and the mean sagittal length 9.8 mm. The follow‐up period ranged from 14 to 64 months. The procedures were uneventful for all patients, and the donor site morbidity was negligible. Twelve months later, the patients were all pain‐free and able to have a regular diet. The TMJ and the knee had a normal range of movement and power. Postoperative imaging demonstrated bone healing and stable and anatomically correct condyle reconstruction. Conclusions Based on the author's experience, the condylar capping with the LFC appears promising for reconstructing the condylar head in cases of severe osteoarthritis. Preserving the attachment of the lateral pterygoid muscle allows a complete restoration of the physiologic range of movement, including protrusion and laterotrusion of the mandible.

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Anatomy of the Vascularized Lateral Femoral Condyle Flap

Cited by 28 publications

References 45 publications

Vascular coverage of the anterior knee region – an anatomical study

Vascular coverage of the anterior knee region – an anatomical study

The fasciocutaneous iliotibial band perforator flap in soft tissue and tendon reconstruction of the foot: A case report

The condylar capping for microvascular temporomandibular joint reconstruction: A preliminary study

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