<< Back to the abstract archive
Case Series of Two Successful Pelvic Ring Reconstruction using A Pedicled Antero-lateral Thigh Flap
Michael Wells, Nicholas Romeo, Kyle Chepla, James Gatherwright
Case Western Reserve University School of Medicine
2021-02-15
Presenter: Michael Wells
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: James Gatherwright
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction:
Orthopedic procedures for pelvic ring fractures are associated with lack of stability, hardware failure, and high risk of contamination/infection from enteral contents. The pedicled anterolateral flap procedure provides immediate, durable soft tissue coverage for vascularized coverage of orthopedic hardware to mitigate these complications.
Case Presentation:
Case #1: The first patient was a 32-year old male admitted for a pelvic fracture/dislocation from a motor vehicle collision (MVC) as a pedestrian. After open reduction and internal fixation, the patient developed a Candida infection of the hardware with compromised soft tissue coverage resulting in communication with the pelvic cavity from the abdomen and bladder. An ALT flap served to cover the pelvic hardware, while a right-sided gracilis flap obliterated the perineal wound. There were no post-operative complications at 12 weeks.
Case #2: The second patient was a 29-year old male who suffered a pelvic crush injury from a MVC as a pedestrian, and was treated with anterior fixation and amputation of the left lower extremity. A composite ALT flap was used for coverage of hardware due to partial loss of the abdominal wall. Three days later, there was Pseudomonas growth with myonecrosis at the amputation site. However, the ALT flap site was spared, and after debridement and antibiotics, the patient did not suffer any additional complications.
Discussion:
The successful outcomes for two patients who underwent ALT flap reconstruction for pelvic ring fractures support this procedure for coverage of exposed tissue/hardware. Prompt surgical intervention is recommended for optimal outcomes of the surgery.
