Download Anterolateral thigh flap

Anterolateral thigh flap
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Described by Song 1984
Predominantly a musculocutaneous perforator (60-80%), 20%-40% septal
perforator between vastus lateralis and rectus femoris
flap is centered in the middle of a line connecting the anterior superior iliac
spine to the lateral border of the patella (between rectus femoris and vastus
lateralis).
circle with a 3-cm radius is centered in the middle of this line. The majority of
perforators is in the inferior external quadrant of the circle.
5% will have no identifiable perforator or vessel between VL and RF
May be pedicled distally - based on the anastamoses between the descending
branch of the LCFA and the lateral superior genicular artery in the knee region.
Raise skin island from anterior to posterior to look for any septocutaneous
branches first
Anatomic preparation of the anterolateral thigh flap (ALTF) and the lateral circumflex
femoral arterial (LCFA) system. The ascending branch of the lateral circumflex
femoral artery (ABLCFA) arises from the transverse branch of the lateral circumflex
femoral artery (TBLCFA). FPA = femoralis profunda artery; LCFV = lateral
circumflex femoral vein; MDBLCFA = medial descending branch of the lateral
circumflex femoral artery; MBVIM = muscular branch of the vastus intermedius
muscle; LDBLCFA = lateral descending branch of the lateral circumflex femoral
artery; PV = perforating vessel.