The lower medial thigh perforator (LMTP) flap for lower extremity reconstruction: Preliminary results

The lower medial thigh perforator (LMTP) flap is an alternative source for lower extremity reconstruction. In this article, we report the preliminary results of reconstruction of the lower extremity with a series of patients by the lower medial thigh perforator flap.

From January 2015 until August 2015, we performed six cases of lower extremity reconstruction with the LMTP flap. The defect locations included the distal leg (1 case) and the proximal leg (2 cases), the left foot (2 cases), and the right foot (1 case). The perforators of the flap design were detected at the distal third of the line, which was drawn from the midpoint of inguinal ligament to medial upper border of patella. The dorsalis pedis artery (2 cases), anterior tibia artery (2 cases), posterior tibial artery (2 cases) were dissected as recipient vessels.

The average size of flap was 10.5 × 5 cm (range 10-15 cm and 4-6.5 cm), and the average pedicle length was 7.6 cm (range 5-9.5 cm). 83% of the perforators (5 of 6) were musculocutaneous type, and 17% (1 of 6) were septocutaneous type. The flap survival rate was 100%; the venous congestion was observed in one flap and was successfully salvaged by performing revised venous anastomosis. The donor sites were all closed primarily with minimal morbidity. Follow-up observations were conducted for 2-6 months, and all patients had good functional recovery with satisfactory cosmetic results.

The lower medial thigh perforator flap has some advantage in lower extremity reconstruction, including adequate length and vessel diameter of pedicle for microvascular anastomosis to the lower extremities recipient vessels. The LMTP flap indicates a low donor-site morbidity and it could be a safe, reliable, and aesthetically appealing new option for lower extremity reconstruction. © 2016 Wiley Periodicals, Inc. Microsurgery 36:474-479, 2016.