A novel technique for trochanteric region soft-tissue reconstruction: coxal region perforator flaps

Abstract

Aims: Due to the complex anatomical structure of the trochanteric region, the options for reconstruction are relatively limited. This study aims to present a unique reconstruction of trochanter defects using a coxal region perforator flap and geometric planning to standardize the flaps. Subjects and Methods: Twelve patients with trochanteric defects that had been repaired with coxal region perforator flap following tumor excision between June 2016 and January 2019 were included in this study. The patients were aged between 20 and 68 years. Patients were evaluated with regard to age, gender, etiology, defect side and size, flap size, number of perforators, and complications. Results: Two patients were operated on for squamous cell carcinoma, one for Marjolin's ulcer, two for malignant melanoma, two for malignant fibrous histiocytoma, and five for dermatofibrosarcoma. Defect sizes ranged between 8 cm × 7 cm and 12 × 10 cm. The smallest flap size was 13 cm × 7 cm and the largest flap size was 21 cm × 10 cm. Nine flaps were raised from the single perforator, and three flaps were raised from two perforators. Venous congestion was seen in one patient postoperatively. There was no flap loss, infection, hematoma, suture detachment, and limitation of hip and knee movements in the patients. Conclusions: The pedicled perforator flaps are elevated over the major perforators located close to the defect in many parts of the body. Thus, low surgical morbidity is achieved, and surgery time is decreased. Furthermore, as in this study, preserving the muscles and preventing the functional deficits in the movement hip joint the body's major joint of the body, reveal the importance of using coxal region perforator flaps for reconstruction in ambulatory patients.