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Distally based anterolateral thigh flap: an anatomic and clinical study
Shin-Chen Pan1, Jui-Chin Yu, Shyh-Jou Shieh
1Division of Plastic and Reconstructive Surgery, Department of Surgery, the Institute of Clinical Medicine, National Cheng-Kung University, Tainan, Taiwan.
Plastic and Reconstructive Surgery
|December 4, 2004
Summary
This study investigated anatomical variations of the descending branch of the lateral circumflex femoral artery to improve distally based anterolateral thigh flap surgery for knee defects. Findings support its safe use with a long pedicle and sufficient tissue for reconstruction.
Area of Science:
- Plastic Surgery
- Anatomy
- Microsurgery
Background:
- The distally based anterolateral thigh flap is utilized for soft-tissue defects around the knee and upper leg.
- This flap relies on perforators from the lateral circumflex femoral artery system.
Observation:
- Anatomical variations of the descending branch of the lateral circumflex femoral artery were examined in cadavers.
- Retrograde blood pressure in this artery was measured in patients.
- The flap's pivot point was consistently located 3-10 cm above the knee in the vastus lateralis muscle.
Findings:
- A consistent connection was noted between the descending branch of the lateral circumflex femoral artery and the knee region's genicular or profunda femoral arteries.
- Flaps up to 7.0 x 16.0 cm were safely harvested without necrosis, with a mean pedicle length of 15.2 cm.
- Retrograde blood pressure averaged 58.3% proximally and 77.7% distally relative to antegrade pressure.
Implications:
- The study provides anatomical data to refine surgical techniques for distally based anterolateral thigh flaps.
- The flap offers advantages like a long pedicle, ample tissue, and donor site suitability.
- It can be combined with fascia lata for tendon reconstruction, preserving major vessels and muscles.