A Cadaveric Comparative Study between Anterolateral Thigh Flap and Posteromedial Thigh Flap

For soft tissue repair, the anterolateral thigh (ALT) flap has been a cornerstone since its inception. The posteromedial thigh (PMT) perforator flap, introduced in 2001, has gained traction over the last decade. This study aims to compare the two flaps to determine which is anatomically more suitable for reconstruction.

Both thighs of 30 cadavers were used for this study over 3 years, involving the dissection of 60 ALTs and 60 PMTs. The comparison focused on the number, length, and type of perforators along with the pedicle length.

The PMT flap showed a higher percentage of septocutaneous perforators while matching the ALT flap in length, number of perforators, and pedicle length. Additionally, the musculocutaneous perforators in the PMT flap had a more straightforward course. The ALT flap had an average of 1.78 perforators, having a mean perforator length of 4.35 cm, while the PMT flap had an average of 1.72 perforators with a mean length of 4.3 cm. The average pedicle length was 11.41 cm for the ALT flap and 9.98 cm for the PMT flap. The ALT flap predominantly featured musculocutaneous perforators (81.3%), whereas the PMT flap had 58.3%.

The PMT flap is comparable to the ALT flap in all evaluated parameters. It offers advantages such as a higher number of septocutaneous perforators, an obscured scar at the donor site, and more soft tissue bulk, making it a viable alternative to the ALT flap.

Ayushree K, Nitisha, Kumari P, et al. A Cadaveric Comparative Study between Anterolateral Thigh Flap and Posteromedial Thigh Flap. Strategies Trauma Limb Reconstr 2025;20(2):66-71.