title: Gastrocnemius myotendinous flap for patellar or quadriceps tendon repair, or both.
abstract: The authors' experience with simultaneous reconstruction of the quadriceps femoris or patellar tendon or both and soft tissue defect using a musculotendinous unit of the gastrocnemius muscle is presented. Five patients with a partial or complete defect of the quadriceps or patellar tendon or both and additional large soft tissue defects underwent reconstruction applying this technique as a one-stage surgical procedure in different variations. In cases with a partial defect of the tendon or loss of tendon thickness, the thick aponeurosis from the deeper aspect of the gastrocnemius was dissected and transferred as a pedicled tendon flap to reconstruct the tendon defect. In cases with a complete defect of the tendon, the superficial layer of the Achilles tendon together with the deep aponeurotic layer of the gastrocnemius muscle served to reconstruct the tendon. In both procedures the gastrocnemius muscle belly provided soft tissue coverage and was covered with a split thickness skin graft. One patient had a marginal deep necrosis develop that had to be covered with the other gastrocnemius muscle in a second operation. One patient with chronic polyarthritis and infection of his knee prosthesis declined additional reconstruction surgery and had the leg amputated. The average followup was 3.5 years. All patients achieved good results in active extension of the knee with an extension deficit of only 5 degrees to 15 degrees. The range of flexion was at least 90 degrees. The surgical technique described in this report provides functional tendon reconstruction and adequate soft tissue repair simultaneously.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Leopold-Franzens University Innsbruck, Ludwig-Boltzmann Institute for Quality Control in Plastic and Reconstructive Surgery, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Rhomberg
authors.forename: A H
authors.initials: AH
authors.lastname: Schwabegger
authors.forename: M
authors.initials: M
authors.lastname: Ninkovic
authors.forename: T
authors.initials: T
authors.lastname: Bauer
authors.forename: M
authors.initials: M
authors.lastname: Ninkovic
mesh_terms: D000293:Adolescent; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D013524:Surgical Flaps; D013708:Tendon Injuries; D013710:Tendons / Q000601:surgery*