PMC7649883_01
A multidisciplinary approach was used to plan the demolition on computerized tomography (CT) images. The oncology-orthopedic surgeon, performed the surgical re-excision following the surgical marking and respecting wide margins ensuring the resection of the surgical field of the previous surgery.
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In addition, we used a random local flap harvested from the popliteal region to cover part of the donor site (Figures 1-3).
In reconstructive time, an adipo-cutaneous propeller flap based on peroneal-perforator of the middle third of the right side and a local-random flap from the popliteal region were planned to cover the defect.
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In addition, we used a random local flap harvested from the popliteal region to cover part of the donor site (Figures 1-3).
Immediate final result of reconstructive surgery. Using different types of loco-regional flaps, it was possible to perform an immediate and safe coverage allowing an early adjuvant radio- and chemotherapy.
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In addition, we used a random local flap harvested from the popliteal region to cover part of the donor site (Figures 1-3).
After 4 months, (white arrow) a painless swelling gradually increasing in size nodule appeared over her right external middle third of the leg into the original proximal part of propeller flap. At the same time, there was a delayed healing of the wound (white asterisks), radiotherapy related, in the previous access for ORIF.
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After 4 months, the patient noticed a painless swelling that gradually increased in size over her right external distal third of the leg; this spot corresponded to the original proximal edge of the propeller flap (Figure 4).
A wide local excision of the suspected translocated recurrence and revision of the wound of the knee was performed.
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We used STSG to cover the muscular flap (Figures 5 and 6).
At the same time, a lateral gastrocnemial proximally based muscular flap was harvested for the revision of ORIF wound and a split-thickness skin graft was used to repair the loss of substance in the left part.
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We used STSG to cover the muscular flap (Figures 5 and 6).
Follow-up: after 2 years and 5 months, no signs of local recurrence or distant localizations. A clinical follow-up every 6 months was planned due to a high risk of recurrence.
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Clinical examination and repeated MRI in November 2019 did not demonstrate any further evidence of the disease (Figure 7).