The gluteus maximus muscle flap for reconstruction of sacral chordoma defects.

Four patients diagnosed with sacral chordoma underwent reconstruction with the gluteus maximus flap using an approach based on available muscle remnants and their residual blood supply. The entire unilateral gluteus maximus muscle was turned over to fill the defect in 2 patients. The flap was based on 1 or 2 gluteal vessels, depending on vessel availability following tumor resection. When all 4 major pedicles had been ligated, bilateral advancement gluteal muscle flaps based on their distal blood supply were used (patient 3). A longitudinally split flap was used for secondary reconstruction of a partially obliterated defect (patient 4). Over a mean follow-up period of 8 months, there was no wound breakdown and all patients were ambulant.