An Atlas of Flaps in Limb Reconstruction Alain C Masquelet Alain Gilbert = i i j S Said See Za mi MARTIN DUNITZContents Foreword, by Raoul Tubiana vii Historical note viii Preface ix Acknowledgements x 1 Historical review 1 2 Vascular anatomy 9 Vascularization of the skin of the limbs and classification of skin flaps 10 Vascular anatomy of muscles: classification 18 The venous drainage in the reverse arterial flow flap 24 Upper limb: tree of flaps and blood supply 28 Lower limb: tree of flaps and blood supply 36 3 Preoperative planning 45 4 Transfers from the upper limb 51 Arm and forearm — 52 Posterior arm flap 52 Lateral arm flap 55 Brachioradialis flap 62 Forearm flaps 66 Posterior interosseous flap 72 Distal ulnar artery flap 78 Hand and digits 83 Kite flap 83 Island flaps from the digits 88 Intermetacarpal and dorsocommissural flaps 93 5 Transfers from the lower limb 95 Thigh 96 Vastus lateralis flap 96 ‘Tensor fasciae latae myocutaneous flap 101 Gracilis flap 104 Biceps femoris flap (long head) 107 Lateral and distal thigh flap 111 ‘Osteoperiosteal flap (from the femur) 115 Leg 118 Fasciocutaneous saphenous artery flap 118 Gastrocnemius flaps 122 Soleus flap 130 Flexor flaps 138 Extensor flaps 143 Peroneus flap 146 Lateral supramalleolar flap 148, Neurocutancous flaps 158 Vascularized fibula transfer 162 Foot 169 Dorsalis pedis flap 169 Extensor digitorum brevis flap 177 Medial plantar flap 183 Medialis pedis flap 189 Abductor hallucis flap 193 Second toe transfer 196 6 Transfers from the thorax, abdomen and pelvis 203 Shoulder girdle 204 Latissimus dorsi flap 206 Serratus anterior flap — 211 Scapular and parascapular flaps 215 Abdomen and pelvis 219 Rectus abdominis flap 220 Groin flap 223 Vascularized iliac crest transfer 226 Osteomyoperiosteal flap 231 Gtuteus maximus flap 233 7 Indications for pedicled island flaps 241 Pedicled flaps of the upper extremity 244 ‘Tissue losses from the shoulder 244 Tissue losses from the arm and hand 246 Pedicled flaps of the lower extremity 251 The pelvic girdle 252 The knee 255 ‘The middle third of the leg 255 ‘The distal third of the leg 257 Foot and ankle 258 Bibliography 261 Index 267