Short Interposed Pedicle of Flow-Through Anterolateral Thigh Flap for Reliable Reconstruction of Damaged Upper Extremity

ABSTRACT Introduction: In a world of fast moving vehicles, heavy machinery and industries crush injury to limbs with vascular compromise and soft tissue defect is common. The traditional treatment is a 2 step one dealing with vascular repair and soft tissue cover separately, in the same operation. We report a series of single step vascular repair and soft tissue cover with flow through anterolateral thigh flap (ALT) flap for limb salvage. Materials and Methods: Ten patients with soft tissue defect and vascular injury were included in this study. A two team approach was used to minimise operative time, team one prepared the vessels and team 2 harvested the flap. Observations and Results: Of the ten patients operated (8 males), eight flaps were done for upper limb and two for lower limb salvage. Six anastomosis were done with ulnar vessels, two with radial and two with posterior tibial vessels. Nine extremities could be salvaged while one patient developed progressive thrombosis leading to amputation. Conclusion: The ALT flow-through flap is a versatile single step procedure that can be used to salvage an ischemic limb with soft tissue loss avoiding the need for interpositional vein graft.

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Flow-through anterolateral thigh flap for a free osteocutaneous fibula flap in secondary composite mandible reconstruction

British Journal of Plastic Surgery ◽

10.1016/j.bjps.2004.02.013 ◽

2004 ◽

Vol 57 (4) ◽

pp. 358-361 ◽

Cited By ~ 18

Author(s):

P Ceulemans ◽

S.O.P Hofer

Keyword(s):

Anterolateral Thigh Flap ◽

Mandible Reconstruction ◽

Fibula Flap ◽

Anterolateral Thigh ◽

Flow Through

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Aesthetic and Functional Outcomes of the Innervated and Thinned Anterolateral Thigh Flap in Reconstruction of Upper Limb Defects

Plastic Surgery International ◽

10.1155/2014/489012 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Carlos Alberto Torres-Ortíz Zermeño ◽

Javier López Mendoza

Keyword(s):

Upper Extremity ◽

Free Flaps ◽

Sensory Function ◽

Anterolateral Thigh Flap ◽

Level Of Evidence ◽

Average Percentage ◽

Aesthetic Result ◽

Anterolateral Thigh ◽

Good Cosmetic ◽

Alt Flap

Background. The anterolateral thigh (ALT) flap has been widely described in reconstruction of the upper extremity. However, some details require refinement to improve both functional and aesthetic results. Methods. After reconstruction of upper extremity defects using thinned and innervated ALT flaps, functional and aesthetic outcomes were evaluated with the QuickDASH scale and a Likert scale for aesthetic assessment of free flaps, respectively. Results. Seven patients with a mean follow-up of 11.57 months and average flap thickness of 5 mm underwent innervation by an end-to-end neurorrhaphy. The average percentage of disability (QuickDASH) was 21.88% with tenderness, pain, temperature, and two-point discrimination present in 100% of cases, and the aesthetic result gave an overall result of 15.40 (good) with the best scores in color and texture. Conclusions. Simultaneous thinning and innervation of the ALT flap lead to a good cosmetic result and functional outcome with a low percentage of disability, which could result in minor surgical procedures and better recovery of motor and sensory function. Level of Evidence. IV.

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