engleski

The use of the anterolateral thigh flap in foot reconstruction

Purpose: Although microsurgical reconstruction of the foot has allowed us to reconstruct foot defects previously requiering amputation the selection of suitable flaps to cover large defects is small. The anterolateral thigh flap, first reported by Song ae al in 1984, can be raised as a large, thin, pliable flap with a consistant pedicle. Do to its many advantages it has been used for numerous clinical applications. In this paper the authors present their experience with the use of the ALT flap in patients with dorsal and plantar defects of the foot. Material and methods: During the past two years the authors have used the ALT perforator flap in eight patients with defects of the plantar and dorsal surfaces of the foot sustained in work or hobby related injuries while a single patient sustained injuries after stepping on an antipersonal mine. Results: The follow up period for this group of patients is from two years to one month. In the early postoperative period two revisions were performed for venous problems. All flaps survived. One flap had partial necrosis which was solved by split skin application to the remaining fascia. The contour of the foot was well preserved most patients could ambulate wearing tennis shoes within three months of the surgery. Conclusion: With the use of the anterolateral thigh flap we have gained a large thin flap which is able to cover large dorsal and plantar defects with good contour restoration and early return of ambulation in normal footwear. The thick and strong fascia lata can be used to stabilise the joints and arches of the foot weakend by destruction of the ligaments, tendons and small muscles of the foot. In addition the donor site, even when covered with a split skin graft, is functionaly and even cosmeticaly acceptable to the patients.

foot reconstruction; anterolateral thigh flap

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