Free Anterolateral Thigh Flaps for Reconstruction of Head and Neck Defects



Free Anterolateral Thigh Flaps for Reconstruction of Head and Neck Defects


I. KOSHIMA





The anterolateral thigh flap is based on the septocutaneous or muscle perforators of the lateral descending branch of the lateral circumflex femoral system. It is useful for reconstruction of defects in the head and neck and in the extremities.





ANATOMY

The lateral circumflex femoral system is composed of three main branches: the ascending branch, which passes through the intermuscular space between the sartorius and vastus lateralis muscles and terminates in the outer cortex of the iliac bone; the transverse branch, which terminates in the tensor fasciae latae muscle; and the (lateral) descending branch, which runs downward through the intermuscular space between the rectus femoris and the vastus lateralis muscles and finally terminates in the vastus muscle near the knee joint. The perforator of the anterolateral thigh flap usually is derived from the transverse branch or the descending branch, and the proximal perforator is situated around the proximal third of the thigh through the lateral longitudinal line of the thigh. Usually, a few cutaneous perforators are found passing through the intermuscular septum or the vastus lateralis muscle. Even in cases with no septocutaneous perforators, there are cutaneous perforators penetrating the vastus lateralis muscle (1, 2, 3, 4, 5, 7, 8) (Fig. 144.1).

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Jun 26, 2016 | Posted by in General Surgery | Comments Off on Free Anterolateral Thigh Flaps for Reconstruction of Head and Neck Defects
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