Knee and Ankle Reconstruction With Reverse Anterolateral Thigh and Free Anterolateral Thigh Flap From One Donor Site

Abstract

Traditionally, the anterolateral thigh (ALT) free flap is used in distal lower extremity reconstruction. Reverse ALT flap has become one of the most popular choices for knee joint soft tissue defects. A 53-year-old man sustained a degloving injury in the right lateral side of the lower extremity from the lateral malleolar area to the knee joint area. The contamination was severe, necessitating serial debridement and negative pressure wound therapy. After 4 weeks, no more soft tissue necrosis was evident. No more microorganism growth was confirmed by swab culture. ALT free flap using proximal perforator was planned for lateral malleolar area reconstruction and reverse ALT flap using distal perforator was planned to cover knee joint after confirming the pedicle length was sufficient for simultaneous knee and lateral malleolar area reconstruction.

Reconstruction of Knee Defects Using Pedicled Gastrocnemius Muscle Flap with Split-Thickness Skin Grafting: A Single Surgeon's Experience with 21 Patients

“…The options for free flap include the latissimus dorsi and free ALT flaps. 5,6 Due to unique anatomy of the knee region, it is relatively difficult to find proper recipient vessels in these patients, many of whom are elderly. 5 Most frequently, free tissue transfer requires repositioning of the patient for exploration of the popliteal artery/vein and their branches to allow microvascular anastomosis.…”