Chimerical anterolateral thigh flap for plantar reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Plantar defects pose significant challenges in reconstructive surgery.
• Achieving functional and aesthetic restoration of the plantar surface is crucial for patient mobility.
• The anterolateral thigh (ALT) flap is a versatile option for soft tissue reconstruction.

Purpose of the Study:

• To evaluate the efficacy of a chimerical anterolateral thigh (ALT) flap for reconstructing plantar defects.
• To assess flap viability, contour, stability, and patient ambulation post-surgery.
• To analyze the sensory recovery of the reconstructed plantar area.

Main Methods:

• Twenty-five patients with plantar defects underwent reconstruction using a chimerical ALT flap (vastus lateralis muscle and thinned skin island).
• Neurorrhaphy was performed in 7 patients, connecting the lateral femoral cutaneous nerve to the calcaneal nerve.
• Flap outcomes, ambulation, and cutaneous sensibility (using Pressure Specified Sensory Device™) were assessed at 6 and 12 months postoperatively.

Main Results:

• Complete flap viability was achieved in 23 patients; 2 experienced partial cutaneous flap loss.
• Good flap contour and stability were observed in all 25 patients by 12 months postoperatively.
• All patients demonstrated good ambulation, and reinnervated flaps showed partial sensory recovery with statistically significant differences compared to the donor site.

Conclusions:

• The chimerical ALT flap is a suitable option for reconstructing plantar defects.
• This technique provides good flap contour, stability, and functional recovery of ambulation.
• The ALT flap offers a low complication rate for plantar defect reconstruction.