title: Chimerical anterolateral thigh flap for plantar reconstruction.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the results of reconstruction and rehabilitation of patients with plantar defects by using a chimerical flap of muscle and skin from anterolateral thigh.
  
  
  METHODS
  Twenty-five patients with plantar defects were reconstructed with a chimerical anterolateral thigh (ALT) flap, composed by a vastus lateralis muscle segment and a thinned skin island. Neurorrhaphy between lateral femoral cutaneous nerve and calcaneal nerve was performed in 7 patients. Evaluation of flap contour and stability and patient ambulation was performed 6 and 12 months after surgery. Evaluation of cutaneous sensiblity of ALT flap and contralateral thigh was performed 12 months after surgery using Pressure Specified Sensory Device™ (PSSD™).
  
  
  RESULTS
  Flap viability was complete in 23 patients and 2 patients had complications with partial flap loss of its cutaneous component. Six months postoperatively, flap contour, and stability was considered good in 19 and 21 patients respectively, and all 25 patients presented good ambulation. Twelve months postoperatively, all 25 patients presented good flap contour and stability, as well as good ambulation. All 7 flaps undergoing to reinnervation partially recovered cutaneous sensibility in comparison to donor site (contralateral thigh). Cutaneous tactile thresholds (g/mm(2) ) of static one-point test and moving one-point test from the ALT flap and the contralateral thigh presented statistically significant differences, for both comparisons (P = 0.009, P = 0.002).
  
  
  CONCLUSIONS
  This flap is suitable for reconstruction of plantar defects, with good flap contour and stability, proper patient ambulation and low complication rates.
authors.affiliation: Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Marcelo V
authors.initials: MV
authors.lastname: Olivan
authors.affiliation: Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Fábio F
authors.initials: FF
authors.lastname: Busnardo
authors.affiliation: Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: José C
authors.initials: JC
authors.lastname: Faria
authors.affiliation: Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Pedro S
authors.initials: PS
authors.lastname: Coltro
authors.affiliation: Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Victor A
authors.initials: VA
authors.lastname: Grillo
authors.affiliation: Division of Plastic Surgery, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Rolf
authors.initials: R
authors.lastname: Gemperli
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000601:surgery*; D018409:Foot Injuries / Q000601:surgery*; D058752:Free Tissue Flaps / Q000637:transplantation*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery*; D013848:Thigh; D016896:Treatment Outcome