Anterolateral thigh flaps for reconstruction of soft tissue defect in lower extremities caused by the Gustilo Ⅲopen fracture / 中华显微外科杂志

ABSTRACT

Objective To evaluate the effectiveness of free anterolateral thigh flaps for the reconstruction of lower extremities vast soft tissue defect caused by Gustilo Ⅲ open fracture. Methods From June,2013 to December, 2016,pedicled vascular anterolateral thigh flaps with end-to-side vascular anastomosis were adopted to repair 10 cas-es of lower legs caused by Gustilo Ⅲ open fracture and soft tissue defects. Among those cases,6 cases combined with anterior tibial arteries injury and 4 cases with posterior tibial arteries injury. The receiving arteries were anastomosed with flaps arteries in end-to-side method and the receiving veins were anastomosed in end-to-end method. All pa-tients were regular follow-up, and follow-up contents included flap appearance, color, limb ischemia. Results All the flaps survived in10 cases. Venous crisis was happened in one case,and flap survived after the exploration. Two cases delayed healing because of wound infection.All the 10 cases were followed up for 3-24 months,with an average of 10 months.The skin flaps of 10 cases were thin and well fitted,with good appearance and soft texture. The color of the flaps were similar to that of the recipient areas.The appearance and function of the affected limbs were satisfacto-ry. Conclusion Free anterolateral thigh flap with end-to-side vascular anastomosis is an ideal method to repair the vast soft tissue defects caused by Gustilo Ⅲ open fracture.