Neural Anatomy of the Anterolateral Thigh Flap

Abstract

The anterolateral thigh (ALT) flap is one of the commonly used sensate flaps for intra-oral, hand, and foot reconstruction. The objective of this study was to describe the anatomic location of the sensory nerves supplying the ALT flap in relation to the surface landmarks and with the vascular pedicles. The dissections were carried out in 28 embalmed specimens. An axial line from the anterior superior iliac spine to the superolateral border of the patella and two circles with radii of 5 and 10 cm centered on the midpoint of the former line were used for the surface landmarks. At the intersection point of the axial line and the 10-cm circle, the main lateral femoral cutaneous nerve (LFCN) and its anterior branch were located within 1 and 2.4 cm, respectively. At the intersection point of the axial line and the 5-cm circle, the anterior branch of the LFCN was located within 2.8 cm. The anterior branch of the LFCN can be detected within 3 cm from the central perforator pedicle in all specimens. The posterior branch of the LFCN, superior perforator nerve, and median perforator nerve were found in more variable locations. The findings from our study provide additional information for clinical use in the planning of sensate ALT flap harvest.

Anatomy of the pedicled anterolateral thigh flap for phalloplasty in transitioning‐males

“…Two other nerves, the superior and median perforator nerves, which are cutaneous sensory branches of the femoral nerve, were found in 25/29 and 24/29 cadavers, respectively (Ribuffo et al, ). They enter the flap at its medial border in its proximal half by emerging through the sartorius muscle or at its lateral margin (Luenam et al, ). Although the lateral cutaneous femoral nerve lies deep, the superior and median perforator nerves lie more superficially and have a role in anterolateral thigh flap innervation (Ribuffo et al, ).…”

Usefulness of a template‐based anterolateral thigh flap for reconstruction of head and neck defects

“…The fasciocutaneous flap could have a double skin paddle if there are two perforators. Moreover, it could be harvested as a sensate flap based on the lateral femoral cutaneous nerve which has an anterior and posterior division, or on cutaneous perforating branches of the femoral nerve (Luenam, Prugsawan, Kosiyatrakul, Chotanaphuti, & Sriya, 2015). An additional benefit is that two-teams can be working simultaneously, with one team resecting the tumor and the other start raising the flap.…”

Reconstrucción con colgajo anterolateral del muslo en un paciente con indicación de amputación infracondílea

“…lateral en el muslo ha permitido, como opción reconstructiva, el desarrollo de los colgajos del músculo tensor de la fascia lata y del colgajo anterolateral del muslo. 1,2 Este colgajo anterolateral se compone de piel y tejido adiposo subcutáneo de la cara anterolateral del muslo, el cual puede proporcionar una extensa área cutánea cuyas dimensiones varían de 25 a 35 cm; además, se puede lograr un colgajo sensitivo al incluir el nervio cutáneo femoral lateral (L2 y L3), conocido también como nervio cutáneo lateral del muslo o nervio femorocutáneo, que sigue un trayecto oblicuo hacia la espina iliaca anterosuperior que pasa en la profundidad del ligamento inguinal hacia el muslo, dividiéndose en los ramos anterior y posterior. 3 Los ramos anteriores emergen a la superficie en un punto situado aproximadamente 10 cm distal al ligamento inguinal e inervan la piel de las porciones lateral y anterior del muslo.…”