Never fear, a perforator will always appear: the use of a perforator flap based on the vasa nervosum of the anterior branch of the femoral cutaneous nerve.

A 30 year old tree surgeon presented to our services with a Gustilo IIIB fracture to his right lower leg. An anterolateral thigh flap was planned for the reconstruction. Intraoperatively, there were no suitable perforators seen and a neurocutaneous perforator flap based on the vessels associated with the anterior branch of the femoral cutaneous nerve was used. The nerve was preserved in the flap harvest. He was discharged and later followed up in clinic with no complications.