Anterior lateral thigh osteomyocutaneous free flap reconstruction in the head and neck: The anterolateral thigh osteomyocutaneous femur bone flap.
The anterolateral thigh (ALT) free flap is one of the most commonly used donor sites in head and neck reconstruction, however, it is not typically considered when an osseous component is needed.



Soft tissue harvests, cadaveric study, and retrospective analysis of a series of 10 patients undergoing angiography were performed to assess vascular supply to the femoral cortex. In 6 patients, corticocancellous split-femur was incorporated into the ALT to reconstruct bony defects of the head and neck.



There is a consistent blood supply to the femur from the lateral femoral circumflex artery both intraoperatively and on angiography. No fractures or orthopedic injuries have been seen to date. None of the patients had complications of bone harvest, such as deep vein thrombosis or pulmonary embolism.



The ALT osteomyocutaneous (ALTO) flap has consistent vascular anatomy to the femoral cortex. This flap provides additional corticocancellous bone and overlying vastus intermedius muscle for the reconstruction of complex craniofacial defects. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1788-1793, 2016.
Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Robert M
RM
Brody
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Nirnimesh C
NC
Pandey
Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Andrés M
AM
Bur
Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Bert W
BW
O'Malley
Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Christopher H
CH
Rassekh
Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Gregory S
GS
Weinstein
Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Ara A
AA
Chalian
Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Jason G
JG
Newman
Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Steven B
SB
Cannady
D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply / Q000637:transplantation*; D006084:Graft Rejection; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000637:transplantation*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D013848:Thigh / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
anterolateral thigh; femur flap; free tissue transfer; head and neck reconstruction; osseocutaneous free flap