title: Distal anastomosis patterns of the descending branch of the lateral circumflex femoral artery.
abstract: BACKGROUND
  The reverse anterolateral thigh (ALT) flap has shown good results in the treatment of patients who have skin and soft tissue defects around the knee and shin. The objective of this study was to show the anastomotic patterns of the descending branch of lateral femoral circumflex artery (db-LCFA) and locate the appropriate pivot point for reverse ALT flap.
  
  
  METHODS
  Fifty thighs from 25 embalmed cadavers from the Anatomy Department, Khon Kaen University in 2012, were dissected. The patterns of distal anastomoses of db-LCFA were recorded and appropriate pivot points for the reverse ALT flap were measured.
  
  
  RESULTS
  Three patterns of distal anastomosis of the db-LCFA were identified, including the anastomoses to the superolateral genicular arteries (46%), anastomoses to the profunda femoral arteries (28%), and unidentified distal anastomoses (26%). The mean distance of the pivot point was 9.4 ± 3.7 cm from the lateral epicondyle. The mean pedicular length was 13.2 ± 5.4 cm (mean ± SD). Most cadavers, 76%, showed a single db-LCFA. In cases where there was more than one db-LCFA, the distal anastomoses were found to be originating from the most medial db-LCFA.
  
  
  CONCLUSIONS
  The reverse ALT flap technique showed good results in the treatment of patients with skin and soft tissue defects around the knee and shin. Variations of the anastomoses and branching patterns of the db-LCFA may influence flap survival. Additional preoperative vascular evaluations would be helpful in defining the most compatible area from which to harvest the flap.
authors: a Department of Orthopaedics, Faculty of Medicine , Khon Kaen University , Thailand and.
authors: Artit
authors: A
authors: Boonrod
authors: a Department of Orthopaedics, Faculty of Medicine , Khon Kaen University , Thailand and.
authors: Tala
authors: T
authors: Thammaroj
authors: a Department of Orthopaedics, Faculty of Medicine , Khon Kaen University , Thailand and.
authors: Surut
authors: S
authors: Jianmongkol
authors: b Department of Anatomy, Faculty of Medicine , Khon Kaen University , Thailand.
authors: Parichat
authors: P
authors: Prajaney
mesh_terms: D002102:Cadaver; D005260:Female; D005263:Femoral Artery / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000098:blood supply; D013848:Thigh / Q000098:blood supply
keywords: Cadaveric study; distal based flap; knee reconstruction; reverse anterolateral thigh flap