The Journal of Bone and Joint Surgery, Vol 69, Issue 4 510-516, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
The use of the vastus lateralis flap in patients with intractable infection after resection arthroplasty following the use of a hip implant
DN Collins, KL Garvin and CL Nelson
Recurrent sepsis and breakdown of the tissues in the operative wound after
resection arthroplasty is performed for a hip with an infection at the site
of an implant present a formidable challenge. A review of the literature
indicates that more than 25 per cent of patients had delayed healing,
additional surgery, or persistent drainage after resection arthroplasty.
Under these circumstances, muscle flaps may help provide definitive
closure, cessation of drainage, and functional recovery of the extremity as
well as a reduction in the length and cost of hospitalization. The
successful use of a vastus lateralis flap in seven patients is described.
The specific advantages are: the flap has a consistent reliably identified
vascular pedicle which permits a wide arc of rotation; sufficient muscle
volume enables large open wounds to be filled; the structural integrity of
the muscle is not violated by previous operations; and no important
functional deficit is attributable to the procedure.