title: Anatomical basis of distally based anterolateral thigh flap.
abstract: Soft tissue coverage around the knee has persisted as a challenge for plastic and reconstructive surgeons. The distally-based anterolateral thigh flap is often used for coverage. Nevertheless, few anatomical studies have investigated the retrograde vascular pedicle. This report clarifies the anatomy of the connection between the descending branch of the lateral circumflex femoral artery and the lateral superior genicular artery. This study examined 38 lower limbs from cadavers and recorded the numbers and locations of perforating vessels. Proximal and distal pivot points were also recorded. The proximal pivot point was 1.0-12.1 cm (average = 6.0 cm) from the inguinal ligament. The distal pivot point, found under the vastus lateralis muscle in all 38 specimens, was 4.0-13.6 cm (average = 9.8 cm) from the lateral superior edge of the patella. The most distal perforator was 8.2-28.0 cm (average = 18.9 cm) from the proximal pivot point. The most proximal perforator was 3.0-19.5 cm (average = 8.7 cm) from the distal pivot point. Details of the anastomosis of the descending branch and the superior lateral genicular artery were clarified. The distally-based anterolateral thigh flap presents one option for reconstruction around the knee.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science , Nagoya City, Aichi , Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.forename: Hideki
authors.initials: H
authors.lastname: Okamoto
authors.forename: Isato
authors.initials: I
authors.lastname: Sekiya
authors.forename: Ikuo
authors.initials: I
authors.lastname: Wada
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Goto
authors.forename: Jun
authors.initials: J
authors.lastname: Mizutani
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nozaki
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Satona
authors.initials: S
authors.lastname: Murakami
authors.forename: Atsunori
authors.initials: A
authors.lastname: Murase
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inatani
authors.forename: Naoe
authors.initials: N
authors.lastname: Tatematsu
authors.forename: Takanobu
authors.initials: T
authors.lastname: Otsuka
mesh_terms: D000328:Adult; D002102:Cadaver; D006801:Humans; D007717:Knee / Q000098:blood supply*; D019651:Plastic Surgery Procedures; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D013848:Thigh / Q000098:blood supply*
keywords: Perforator flap; anatomy; anterolateral thigh flap; distally-based