Distally Based Iliotibial Band Flap: Anatomic Study with Surgical Considerations.

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Citation: Journal of Reconstructive Microsurgery. 32(7):551-5, 2016 SepPMID: 27135145Institution: Curtis National Hand CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Bone Transplantation/mt [Methods] | *Knee Joint/su [Surgery] | *Microsurgery | *Muscle, Skeletal/su [Surgery] | *Reconstructive Surgical Procedures | *Surgical Flaps/bs [Blood Supply] | *Tendons/tr [Transplantation] | Adult | Aged | Aged, 80 and over | Cadaver | Dissection | Femur/ah [Anatomy & Histology] | Femur/tr [Transplantation] | Humans | Knee Joint/ah [Anatomy & Histology] | Knee Joint/pa [Pathology] | Middle Aged | Models, Anatomic | Muscle, Skeletal/ah [Anatomy & Histology] | Muscle, Skeletal/pa [Pathology] | Tissue and Organ HarvestingYear: 2016ISSN:
  • 0743-684X
Name of journal: Journal of reconstructive microsurgeryAbstract: Background Reconstruction of high-risk fascia, tendon, or ligament defects may benefit from vascularized tissue. The iliotibial band (ITB), a thick fibrous tract of connective tissue, serves as a potential donor site for free tissue transfer but its blood supply has not been thoroughly investigated. The aim of this anatomical study was to investigate the vascular supply to the distal ITB and its role as a free fascial flap. Methods We dissected 16 fresh-frozen cadaveric legs and injected latex into the superolateral geniculate artery (SLGA). A distal ITB fascial flap was designed and measurements were taken for flap dimensions, pedicle length and size, and SLGA perfusion territory. Results The SLGA perfused 11.5+/-2.3 cm of distal ITB (proximal to the lateral femoral epicondyle) and provided 6.4+/-0.7cm of pedicle length to the ITB flap. Conclusions Chimeric options to include bone (from the lateral femoral condyle), cartilage (from the lateral femoral trochlea), muscle (from vastus lateralis or biceps femoris), and skin are possible. Surgical harvest techniques are proposed, including preservation of ITB insertions to minimize lateral knee instability. Clinical validation is needed to determine the role of the distal ITB free fascial flap in reconstructive microsurgery. Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.All authors: Higgins JP, Wong VWFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-12-13
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Journal Article MedStar Authors Catalog Article 27135145 Available 27135145

Background Reconstruction of high-risk fascia, tendon, or ligament defects may benefit from vascularized tissue. The iliotibial band (ITB), a thick fibrous tract of connective tissue, serves as a potential donor site for free tissue transfer but its blood supply has not been thoroughly investigated. The aim of this anatomical study was to investigate the vascular supply to the distal ITB and its role as a free fascial flap. Methods We dissected 16 fresh-frozen cadaveric legs and injected latex into the superolateral geniculate artery (SLGA). A distal ITB fascial flap was designed and measurements were taken for flap dimensions, pedicle length and size, and SLGA perfusion territory. Results The SLGA perfused 11.5+/-2.3 cm of distal ITB (proximal to the lateral femoral epicondyle) and provided 6.4+/-0.7cm of pedicle length to the ITB flap. Conclusions Chimeric options to include bone (from the lateral femoral condyle), cartilage (from the lateral femoral trochlea), muscle (from vastus lateralis or biceps femoris), and skin are possible. Surgical harvest techniques are proposed, including preservation of ITB insertions to minimize lateral knee instability. Clinical validation is needed to determine the role of the distal ITB free fascial flap in reconstructive microsurgery.

Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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