Vastus lateralis muscle flap for infected hip defects: a report of four cases

Background: Infected prosthetic hip joints can often be salvaged through one- or two-stage procedures. When these measures fail and prosthesis has to be removed, an infected defect is created that has very little chance of being closed directly or by secondary healing. It is well established that such defects can be successfully closed with the introduction of a well vascularized tissue, such as muscle, into the defect. Methods: We present four patients with infected hip defects following prosthesis extraction who were treated with vastus lateralis pedicled flaps transposition. Results: All four patients were successfully treated using the vastus lateralis muscle flap, with no signs of infection and a stable skin coverage in all of the patients to date. Conclusions: We found vastus lateralis to be a reliable and sufficiently large flap for closure of infected hip defects. A small technical point of leaving the suction drain in the recipient site for 14 days is suggested. Having observed a great number of operations performed on these patients and a long waiting time before closure of the defect is achieved, we recommend a much closer collaboration between orthopedic and plastic surgeons.