Limits...
MR imaging appearances of soft tissue flaps following reconstructive surgery of the lower extremity.

Magerkurth O, Girish G, Jacobson JA, Kim SM, Brigido MK, Dong Q, Jamadar DA - Korean J Radiol (2015)

Bottom Line: Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect.The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare.Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Hospital Baden, Baden 5405, Switzerland.

ABSTRACT
MR imaging appearances of different types of reconstructive muscle flaps following reconstructive surgery of the lower extremity with associated post-surgical changes due to altered anatomy, radiation, and potential complications, can be challenging. A multidisciplinary therapeutic approach to tumors allows for limb salvage therapy in a majority of the patients. Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect. Hematomas and infections are early complications that can jeopardize flap viability. The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare. Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.

Show MeSH

Related in: MedlinePlus

57-year-old paraplegic female with right ischial osteomyelitis and pressure ulcer, underwent partial ischiectomy and wound closure with gluteus maximus muscle flap.A. Preoperative axial gadolinium enhanced T1-weighted image with fat saturation. Note periostal reaction and loss of cortical outline of right ischium (*). Also, note extensive right gluteal hyper intensity interpreted as edema and abscess (arrow) posterolateral to right ischium (*). B. Postoperative coronal T1-weighted image. Persistent changes of osteomyelitis (*) show low signal in right ischium. C. Postoperative axial T2-weighted image with fat saturation. Note inferomedial relocation of gluteus maximus muscle (M) on right, resulting in significant soft tissue asymmetry (involving both muscle and fat) compared to normal left ischial region. D. Postoperative axial T1-weighted image at same level showing resolving ischial bone changes (*) following additional antibiotic therapy. S = symphysis pubis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4296265&req=5

Figure 2: 57-year-old paraplegic female with right ischial osteomyelitis and pressure ulcer, underwent partial ischiectomy and wound closure with gluteus maximus muscle flap.A. Preoperative axial gadolinium enhanced T1-weighted image with fat saturation. Note periostal reaction and loss of cortical outline of right ischium (*). Also, note extensive right gluteal hyper intensity interpreted as edema and abscess (arrow) posterolateral to right ischium (*). B. Postoperative coronal T1-weighted image. Persistent changes of osteomyelitis (*) show low signal in right ischium. C. Postoperative axial T2-weighted image with fat saturation. Note inferomedial relocation of gluteus maximus muscle (M) on right, resulting in significant soft tissue asymmetry (involving both muscle and fat) compared to normal left ischial region. D. Postoperative axial T1-weighted image at same level showing resolving ischial bone changes (*) following additional antibiotic therapy. S = symphysis pubis

Mentions: In most cases, the pelvis and thigh offer enough soft tissue volume and several potential long donor muscles which are amenable to adequate mobilization and rotation to cover the defects without compromising vascularity. Common donor muscles include the tensor fascia lata (Fig. 1), biceps femoris, rectus femoris, and the gluteus muscles (Fig. 2) (11, 12, 13).


MR imaging appearances of soft tissue flaps following reconstructive surgery of the lower extremity.

Magerkurth O, Girish G, Jacobson JA, Kim SM, Brigido MK, Dong Q, Jamadar DA - Korean J Radiol (2015)

57-year-old paraplegic female with right ischial osteomyelitis and pressure ulcer, underwent partial ischiectomy and wound closure with gluteus maximus muscle flap.A. Preoperative axial gadolinium enhanced T1-weighted image with fat saturation. Note periostal reaction and loss of cortical outline of right ischium (*). Also, note extensive right gluteal hyper intensity interpreted as edema and abscess (arrow) posterolateral to right ischium (*). B. Postoperative coronal T1-weighted image. Persistent changes of osteomyelitis (*) show low signal in right ischium. C. Postoperative axial T2-weighted image with fat saturation. Note inferomedial relocation of gluteus maximus muscle (M) on right, resulting in significant soft tissue asymmetry (involving both muscle and fat) compared to normal left ischial region. D. Postoperative axial T1-weighted image at same level showing resolving ischial bone changes (*) following additional antibiotic therapy. S = symphysis pubis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296265&req=5

Figure 2: 57-year-old paraplegic female with right ischial osteomyelitis and pressure ulcer, underwent partial ischiectomy and wound closure with gluteus maximus muscle flap.A. Preoperative axial gadolinium enhanced T1-weighted image with fat saturation. Note periostal reaction and loss of cortical outline of right ischium (*). Also, note extensive right gluteal hyper intensity interpreted as edema and abscess (arrow) posterolateral to right ischium (*). B. Postoperative coronal T1-weighted image. Persistent changes of osteomyelitis (*) show low signal in right ischium. C. Postoperative axial T2-weighted image with fat saturation. Note inferomedial relocation of gluteus maximus muscle (M) on right, resulting in significant soft tissue asymmetry (involving both muscle and fat) compared to normal left ischial region. D. Postoperative axial T1-weighted image at same level showing resolving ischial bone changes (*) following additional antibiotic therapy. S = symphysis pubis
Mentions: In most cases, the pelvis and thigh offer enough soft tissue volume and several potential long donor muscles which are amenable to adequate mobilization and rotation to cover the defects without compromising vascularity. Common donor muscles include the tensor fascia lata (Fig. 1), biceps femoris, rectus femoris, and the gluteus muscles (Fig. 2) (11, 12, 13).

Bottom Line: Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect.The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare.Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Hospital Baden, Baden 5405, Switzerland.

ABSTRACT
MR imaging appearances of different types of reconstructive muscle flaps following reconstructive surgery of the lower extremity with associated post-surgical changes due to altered anatomy, radiation, and potential complications, can be challenging. A multidisciplinary therapeutic approach to tumors allows for limb salvage therapy in a majority of the patients. Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect. Hematomas and infections are early complications that can jeopardize flap viability. The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare. Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.

Show MeSH
Related in: MedlinePlus