J Reconstr Microsurg 2004; 20(4): 291-295
DOI: 10.1055/s-2004-824886
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Dysvascular Lower Extremity Reconstruction Using Free Flaps with a “Y” Configuration of the Arterial Pedicle

Hiroshi Yajima1 , Yasunori Kobata1 , Koji Shigematsu1 , Kenji Kawamura1 , Shohei Omokawa1 , Yoshinori Takakura1
  • 1Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
Further Information

Publication History

Accepted: 6 January 2004

Publication Date:
19 April 2004 (online)

For patients with a dysvascular lower extremity, free flaps have been transferred by end-to-side anastomosis, in order to maintain peripheral circulation. For such patients, the authors have applied free flap transfers with a “Y” configuration of the arterial pedicle. Eight free flaps with a Y configuration of the arterial pedicle were used in seven patients: latissimus dorsi musculocutaneous flaps in six, and scapular flaps in two. For the former, flaps were harvested with the subscapular and circumflex scapular arteries forming a Y pedicle in three cases, and with the thoracodorsal artery and the branch of the serratus anterior muscle in three. For the scapular flap transfers, the flap was harvested with the subscapular and thoracodorsal arteries forming a Y pedicle in one case, and with the circumflex scapular artery and the descending branch in the other. This procedure was performed for single-artery extremities in two cases. One developed arterial thrombosis of the branch to the foot, but removal of the thrombus and reanastomosis resulted in peripheral blood circulation being maintained. Eventually, all flaps survived. This procedure is indicated in patients with lower-leg reconstruction, especially with vascular disease.

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Hiroshi YajimaM.D. 

Department of Orthopaedic Surgery, Nara Medical University

840 Shijyo-cho, Kashihara

Nara 634-8522, Japan