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Knee reconstruction using a distally based anterolateral thigh flap: an anatomical cadaveric study
Kamonwan Jenwitheesuk1, Phonnapas Sukprasert1, Kengkart Winaikosol1
1Plastic and Reconstructive Division, Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand.
Journal of Wound Care
|September 13, 2018
Summary
The distally-based anterolateral thigh (dbALT) flap offers reliable perforator sites for soft tissue reconstruction around the knee. This study details the vascular anatomy crucial for effective dbALT flap design.
Area of Science:
- Anatomy
- Plastic Surgery
- Microsurgery
Background:
- The descending branch of the lateral circumflex femoral artery is key for anterolateral thigh flaps.
- Understanding its perforator anatomy is vital for reconstructive surgery, particularly for distal thigh and leg defects.
Purpose of the Study:
- To map the vascular territory of the descending branch of the lateral circumflex femoral artery.
- To identify cutaneous perforators for the distally-based anterolateral thigh (dbALT) flap.
- To analyze perforator location and number for optimal flap design.
Main Methods:
- Dissection of fresh cadaveric lower limbs.
- Detailed description of perforator branches originating above the knee.
- Measurement of perforator distance from the superior-lateral border of the patella.
Main Results:
- 54 cadavers showed at least two perforator branches above the knee.
- The mean distance of the first perforator was 2.57±0.93cm superior to the lateral patella.
- Perforator locations were consistently identified at 10±2cm and 20±3cm from the superior lateral patella.
Conclusions:
- The dbALT flap technique provides consistent and reliable perforator landmarks.
- This flap is a viable reconstructive option for soft tissue defects of the knee and upper leg.
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