Assessment of Donor-Site Morbidity following Rectus Femoris Harvest for Infrainguinal Reconstruction

Abstract

Advantages of the pedicled rectus femoris myofascial flap for groin wound coverage include a sufficient arc of rotation to reach the groin and inguinal region, a dependable vascular pedicle, and low donor-site morbidity. The authors aim to demonstrate the functional deficit resulting from use of the rectus femoris flap in groin wound reconstruction. One hundred six rectus femoris flaps were performed for groin wound reconstruction over a 10-year period. From this cohort, consent was successfully obtained from 20 patients for testing of thigh function. Testing included both a subjective questionnaire eliciting patient assessment of postoperative thigh strength, and objective muscle strength testing using isometric dynamometer analysis. An age- and sex-matched control group of 20 subjects with no operative history or known discrepancy of thigh strength underwent identical testing. : Subjects were tested an average of 33 months postoperatively. Dynamometer studies demonstrated a mean nonoperative and operative thigh peak torque of 135 ft-lb and 104 ft-lb, respectively, or a 21 percent difference in isometric knee extensor strength favoring the dominant leg (p = 0.02). Similarly, the control group exhibited a 17 percent strength difference between both thighs (p = 0.04). Operative subjects exhibited a lower peak torque generated by the operative leg relative to the nonoperative leg. However, a similar difference was observed in the matched control cohort. Thus, there is little isolated deficit in quadriceps strength as a result of rectus femoris harvest.