Efficacy of Color Duplex Ultrasonography in Mapping of Perforators Around Knee Joint and its Correlation with Surgical Findings
Saad Hassan Abd El-Raheem;
Abstract
Soft tissue defects in the knee region present a challenging problem which can interfere with upright posture and bipedal locomotion. Perforator based flaps have been used to resurface the tissue defect being preserving
muscle function, sparing the main vascular trunks, replacing "like with like", donar site can often be closed primarily, the and good cosmetic result can be achieved.
Preoperative planning of the perforator flap can not be based on a rigid set of anatomical rules. So many methods were developed to ensure the presence and precise location of these perforators before raising the flaps.The mapping of the perforators in the knee region by radiological methods makes the surgical technique easier by decreasing the dissection and time safing with decreasing the complication rate.
The current study included 40, patients was divided into two parts, where in part I mapping of the perforators in the knee region was done by color duplex ultrasonography, while in part II surgical identification of the perforators and perforator based flap were performed.
The radiological scan by color duplex in the midline and medial side below the knee to identify the perforators revealed an average 1- 3 perforators from the medial sural artery in each limb. Location of the perforators from medial sural artery was found in a special manner as follows, the perforators "on" medial head of gastrocnemius muscle midline were found 11.23±3.27cm from the popliteal crease, the perforators "within" 1cm medial or lateral to medial head of gastrocnemius muscle midline were 11.47± 2.83cm from the popliteal crease and the perforators "out" of 1cm from that line were located 11.33± 3.36cm from the popliteal crease . All of them were musculocutaneous perforators with indirect course and gathered in an area between 0.5cm and 4.5cm from the midline of the gastrocnemius muscles.We did not find major difference between the preoperative color duplex studying and intraoperative findings as regard the site and size.
muscle function, sparing the main vascular trunks, replacing "like with like", donar site can often be closed primarily, the and good cosmetic result can be achieved.
Preoperative planning of the perforator flap can not be based on a rigid set of anatomical rules. So many methods were developed to ensure the presence and precise location of these perforators before raising the flaps.The mapping of the perforators in the knee region by radiological methods makes the surgical technique easier by decreasing the dissection and time safing with decreasing the complication rate.
The current study included 40, patients was divided into two parts, where in part I mapping of the perforators in the knee region was done by color duplex ultrasonography, while in part II surgical identification of the perforators and perforator based flap were performed.
The radiological scan by color duplex in the midline and medial side below the knee to identify the perforators revealed an average 1- 3 perforators from the medial sural artery in each limb. Location of the perforators from medial sural artery was found in a special manner as follows, the perforators "on" medial head of gastrocnemius muscle midline were found 11.23±3.27cm from the popliteal crease, the perforators "within" 1cm medial or lateral to medial head of gastrocnemius muscle midline were 11.47± 2.83cm from the popliteal crease and the perforators "out" of 1cm from that line were located 11.33± 3.36cm from the popliteal crease . All of them were musculocutaneous perforators with indirect course and gathered in an area between 0.5cm and 4.5cm from the midline of the gastrocnemius muscles.We did not find major difference between the preoperative color duplex studying and intraoperative findings as regard the site and size.
Other data
| Title | Efficacy of Color Duplex Ultrasonography in Mapping of Perforators Around Knee Joint and its Correlation with Surgical Findings | Other Titles | دراسة كفاءة الدوبلكس الملون فى رسم خريطة الشرايين الثاقبة حول الركبة ومقارنتها مع النتائج الجراحية | Authors | Saad Hassan Abd El-Raheem | Issue Date | 2014 |
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