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CC BY 4.0 · Rev Bras Ortop (Sao Paulo)
DOI: 10.1055/s-0044-1779308
Relato de Caso

Popliteal Neurovascular Bundle Medialization and Axial Flap Rotation to Avoid Bone Impingement in Tibial Turn-Up Plasty: A Case Report

Article in several languages: português | English
Manuel Ricardo Medellin Rincon 
1   Departmento de Cirurgia Ortopédica, Grupo Bogotano de Ortopedia y Sarcomas, Bogotá, Colômbia
,
Oscar Fernando Gomez-Ricaurte 
1   Departmento de Cirurgia Ortopédica, Grupo Bogotano de Ortopedia y Sarcomas, Bogotá, Colômbia
,
Hermann Alfredo Riveros-Riveros 
1   Departmento de Cirurgia Ortopédica, Grupo Bogotano de Ortopedia y Sarcomas, Bogotá, Colômbia
,
Andrea Sambri 
2   Departmento de Cirurgia Ortopédica, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Itália
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Abstract

A 33-year-old male patient developed distal femur chronic osteomyelitis with massive bone loss after an open grade-3b fracture. Following several failed treatments to eradicate infection, a tibial turn-up procedure was performed to provide a stable and functional stump. To avoid neurovascular problems, the popliteal vessels and sciatic nerve were moved medially, and the flap was rotated externally to decrease the collapse. The progression after surgery was satisfactory, no vascular or neurological claudication was observed, and the patient has been able to wear an external prosthesis after flap healing. Tibial turn-up plasty is a rarely described reconstructive technique capable of providing longer stumps. The releasing and medialization of popliteal vessels, with axial rotation of the flap, may prevent the development of neurovascular impingement.

Keywords

amputation stumps - bone transplantation - osteomyelitis - surgical flaps

Financial Support

The present research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.


* Work developed at the Clinica Nueva, Calle, Bogotá, Colombia.




Publication History

Received: 09 March 2023

Accepted: 29 May 2023

Article published online:
23 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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