Copertura di una difficile perdita di sostanza a livello del ginocchio mediante trasposizione del muscolo sartorio.

Abstract: the combined orthopedic and plastic surgical approach to the injured lower extremity has permitted successful salvage of otherwise severely injured limbs. The coverage of soft-tissue defects around the knee joint presents a difficult challenge to the reconstructive surgeon. Various reconstructive choices are available depending on the location, size, and depth of the defect relative to the knee joint. However, the knee joint wound frequently accompanies injuries to the lower extremities that may limit the use of muscle flaps. The use of a free flap is preferred for reconstruction involving obliteration of large-cavity defects, but the isolation of recipient pedicle can be difficult because of the extent of injury zone and in cases of chronic infection around the knee. To provide muscle bulk with a reliable vascular supply, the Sartorius muscle flap transposition was used as a first choise to reconstruct a difficult wound with chronic osteomyelitis around the knee joint. This method is a two-stage procedure. First, the Sartorius muscle is dissected and all the vascular pedicles are identified than the muscle is transposed to reconstruct the soft-tissue defect around the knee. Second, when the granulation tissue is arise 15 days after, a skin graft is harvested. Sartorius muscle transposition can be considered when free flaps or fasciocutaneous flaps are not available.