Use of the anterolateral thigh free flap for upper-extremity reconstruction.
OBJECTIVE
The anterolateral thigh free flap (ALTF) first was reported in 1984 and has been used in large series with success for a multitude of clinical purposes. We describe our results with the ALTF in upper-extremity and hand reconstruction.


METHODS
From 1996 to 2003 there were 15 patients who had reconstruction of the hand and upper extremity using the ALTF. The parameters used to assess the outcome of our series included the success rate of the flap as measured by flap survival rate and adequacy of skin coverage, ability to close the donor site primarily or necessity of a skin graft, complications associated with the flap, donor site, and non-flap-related complications such as pulmonary embolism.


RESULTS
Of the 15 patients with an ALTF, 3 (20%) had a musculocutaneous perforator and 12 (80%) had a septocutaneous perforator. Two patients had a neurotized ALTF reconstruction. There were 4 complications related to the flap with 1 complete flap failure. The overall flap survival rate was 93%. The donor site was closed primarily in 8 patients (53%) and with a skin graft in 7 patients (47%). One donor site breakdown occurred.


CONCLUSIONS
Our results show many advantages of the ALTF for upper-extremity reconstruction. Because of its versatility the ALTF is suited ideally for upper-extremity reconstruction and should be considered as part of the reconstructive ladder.
Wang
Howard T
HT
Division of Orthopedics and Plastic, Reconstructive, Maxillofacial, and Oral Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Fletcher
James W
JW
Erdmann
Detlev
D
Levin
L Scott
LS
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005542:Forearm / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013848:Thigh