Lower Extremity Reconstruction Using Vastus Lateralis Myocutaneous Flap versus Anterolateral Thigh Fasciocutaneous Flap

Background The anterolateral thigh (ALT) perforator flap has become a popular option fortreating soft tissue defects of lower extremity reconstruction and can be combined witha segment of the vastus lateralis muscle. We present a comparison of the use of the ALTfasciocutaneous (ALT-FC) and myocutaneous flaps.Methods We retrospectively reviewed patients in whom free-tissue transfer was performedbetween 2005 and 2011 for the reconstruction of lower extremity soft-tissue defects. Twentyfourpatients were divided into two groups: reconstruction using an ALT-FC flap (12 cases) andreconstruction using a vastus lateralis myocutaneous (VL-MC) flap (12 cases). Postoperativecomplications, functional results, cosmetic results, and donor-site morbidities were studied.Results Complete flap survival was 100% in both groups. A flap complication was noted inone case (marginal dehiscence) of the ALT-FC group, and no complications were noted in theVL-MC group. In both groups, one case of partial skin graft loss occurred at the donor site,and debulking surgeries were needed for two cases. There were no significant differences inthe mean scores for either functional or cosmetic outcomes in either group.Conclusions The VL-MC flap is able to fill occasional dead space and has comparable survivalrates to ALT-FC with minimal donor-site morbidity. Additionally, the VL-MC flap is easily elevatedwithout myocutaneous perforator injury.