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

Background: 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. Methods: 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. Results: 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). Conclusions: 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. (Plast. Reconstr. Surg. 126: 933, 2010.)