Anterolateral Thigh Flap With Kiss Technique for Major Joint Contracture

The anterolateral thigh (ALT) flap is one of the methods for treating joint contractures. However, the design of the ALT flap has not been sufficiently discussed. Herein, we describe our kiss ALT flap design for treating postburn joint contractures with satisfactory results. The patient is a 33-year-old man with scar contractures caused by flame burns in various areas of his body. We performed a kiss ALT flap transfer on a particularly symptomatic right knee. Postoperatively, the patient had no complications, and the joint range of motion improved. The key to designing our kiss ALT flap is to split the long ALT flap diagonally. The advantages of this design are that the dog ear can be used effectively, the flap size matches the skin defect at the joint, and the joint between the 2 divided flaps matches the joint fossa. The same technique has been used to treat axillary scar contractures with good results. A split ALT flap with the kiss technique for major joint contractures may be useful when 2 or more perforating vessels are available.