Pedicled Internal Oblique Rotational Muscle Flap for Reconstruction of Post-Traumatic Lateral Pelvic Defects: Report of Four Cases

Reconstruction of complex post traumatic pelvic defects presents a challenge to the plastic surgeon. Various local and distant flaps have been utilized for coverage of pelvic defects including the sartorius, rectus abdominis, rectus femoris, tensor fasciae latae, vastus lateralis, gracilis, and omentum – each with inherent benefits and disadvantages. The pedicled internal oblique rotational muscle flap has been described to cover pelvic wounds; however, it may be underutilized. The authors reported their recent experience with the use of five pedicled internal oblique muscle flaps in four patients. There were three males and one female, with a mean age of 32 years (range: 23–47 years), and mean follow-up time of 8 months. All patients required definitive soft tissue coverage of the lateral pelvis after failure of conservative measures. There were no major complications and no incidence of postoperative abdominal wall herniation. One patient experienced a temporary decrease of sensation in the distribution of the ipsilateral lateral femoral cutaneous nerve which resolved fully within 3 months. The internal oblique muscle provides local soft tissue coverage with a predictable blood supply. Furthermore, its proximity to the pelvis offers a practical alternative for reconstruction of complex lateral pelvic defects with minimal associated morbidity.