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We report our experience with two cases of anterolateral thigh flaps based on the musculocutaneous perforators arising from a more distal part of the descending branch than in the conventional anterolateral thigh flap. Case 1: A 53-year-old man with a skin ulcer over the anterior surface of the left tibia secondary to plate fixation for an open fracture. The perforator marked with preoperative Doppler was located 8 cm proximal to the superior border of the patella. Without thinning, the flap was 10 × 4 cm in size and 5 mm thick. Case 2: A 46-year-old man with necrosis of the right index finger after replantation. The flap was 5 × 3 cm in size and 3 mm in thickness. This “distal” anterolateral thigh flap can be raised as a quite thin flap with a long pedicle and, therefore, is considered useful in the reconstruction of various soft tissue defects.
Tumor free-margin surgical resection remains the single most
important treatment in the curative therapy of musculoskeletal tumor of limbs.
Refinements in surgical techniques have led to increased
function preservation and limb salvage. Patients and Methods: The records of patients (n = 24) who underwent microsurgical soft tissue
reconstruction subsequent to resection of limb tumour during the period 2006 to
2011 were reviewed. Primary outcome i.e. uptake of the flap was evaluated. Perioperative morbidities were also noted including donor as well as
recipient site complications. Assessment of Functional outcome (Musculoskeletal
Tumor Society score, MSTS) local recurrence, free survival, and
disease-specific survival was also made. Results: Twenty four patients (age range: 7 - 72 years) who have undergone tumor resection
followed by flap coverage were identified. Lower limb reconstruction
outnumbered upper limb by 6:1. Complications included, one complete failure of
free vascularized iliac crest flap done for reconstruction of a