Abstract
Background Distal lower extremity reconstruction presents many challenges due to the suboptimal
vascular supply, the weight-bearing necessity, movement, and multiple tissue types
that can be easily damaged by trauma, from bones, tendons, ligaments, muscle, and
soft tissue loss. The anterolateral thigh flap provides a reconstructive option for
large defects with good coverage and minimal donor-site morbidity.
Methods After a chart review of all anterolateral thigh flaps, the patients were contacted
to take a survey regarding their satisfaction and functional ability and to meet for
measurements of their feet after debulking procedures.
Results A total of 13 patients were included in the study, with traumatic injuries comprising
84% of cases. There was a significant difference in sizes of the midfoot (mean: 10.27
vs. 9.53, p = 0.004) and the hindfoot (mean: 12.92 vs. 12.2, p = 0.023) when comparing the affected side to the unaffected side. The majority, 77%,
of our patients underwent debulking procedures. Overall, 75% of traumatic injury patients
had > 90% maximum functionality score. All posttraumatic reconstruction results were
rated satisfied to very satisfied by the patients. All posttraumatic patients were
able to walk after their procedures, although three patients did require custom-made
shoes with inserts or braces.
Conclusion The anterolateral thigh flap is a versatile reconstructive option that can be used
in the distal lower extremity and is especially useful after a traumatic injury as
it allows for functional recovery and high patient satisfaction after debulking.
Keywords
anterolateral thigh flap - soft tissue reconstruction - lower extremity
