Reconstruction of the quadriceps apparatus following open injuries to the knee joint using pedicled gastrocnemius musculotendinous unit as bridge graft

Reconstruction of Complete Knee Extensor Mechanism Loss with Gastrocnemius Flaps

“…Babu et al [1] used the medial gastrocnemius flap in reconstruction in two patients, one of whom had a chronic isolated injury and the other had an acute isolated injury. These patients with isolated injuries had excellent results.…”

“…Rhomberg et al [9] described folding the aponeurosis to increase the strength of reconstruction. We followed the technique described by Babu et al [1], which seemed to be adequate. The paucity of literature regarding extensor mechanism loss after trauma may indicate this problem is underreported or such patients are treated with arthrodesis.…”

“…The fascia on the undersurface of the intervening skin bridge was incised to make sure the flap was not compressed. After the muscle belly was transferred anteriorly, it was made to lie obliquely across the defect as performed by Babu et al [1]. The tough aponeurosis was sutured to both sides of the defect in the extensor mechanism.…”

“…However, the usefulness of this technique in infected traumatic extensor mechanism defects has not been reported often [1,7]. We used the gastrocnemius because of our experience with its reliability for coverage of the knee and proximal tibia.…”

Flap Cover Options for Knee Soft Tissue Defects – An Institutional Experience.

“…Muscle flaps obliterate the dead space and provide rich blood supply that facilitates the local antibiotic delivery and humoral immunity. Options available are GASTROCNEMIUS [2,6,10], VASTUS LATERALIS, VASTUS MEDIALIS, GRACILIS AND SARTORIUS. Among them, Gastrocnemius and Vastus Lateralis muscle flaps are commonly used.…”