Venous Augmentation of Distally Based Pedicled ALT Flap to Reconstruct the Tibial Tuberosity in a Severely Injured Leg

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

“…But, more recent evidence has clarified the flap's physiology and confirmed that it is safe. [5][6][7][8][9] Anastomosis between the lateral circumflex femoral artery and lateral superior geniculate artery or profunda femoral artery in the knee joint is the vascular basis of the reverse ALT flap. 9 A cadevaric study revealed that the pivot point ranges between 3 and 10 cm above the superior lateral patella border, with the pedicle averaging 15 cm in length.…”

“…The reverse ALT has many merits including long pedicle length and large skin paddle. [5][6][7][8][9] In distal lower extremity reconstruction, several local flaps have been proposed. In patients with severe soft tissue defects, the free flap is the preferred option due to the large skin paddle and suitable thickness.…”

“…3,4 In knee joint reconstruction, reverse (distally based) ALT flap has become one of the most popular choices for lower extremity surgeons. [5][6][7][8][9] We present the case of a patient who had simultaneous severe soft tissue defect in a knee and lateral malleolar area due to trauma. The knee and lateral malleolar area were reconstructed in one stage, without changing position, using a reverse ALT flap and ALT free flap from one donor site.…”

The distally based, venous supercharged anterolateral thigh flap

“…Despite the study limitations (retrospective study, small number of cases, no homogenous group of patients), this manuscript clearly signifies the necessity for venous supercharging of the distally based anterolateral thigh flap. We have reported the venous augmentation of distally based pedicled ALT flap in March 2009 (Gravvanis & Britto, 2009), and we are very pleased to see the first series published based on this concept. We have stated that venous supercharging of the flap can eliminate vascular problems, and we strongly recommended it as routine procedure ( Figure 1) (Gravvanis & Britto, 2009).…”

Novel technique for reconstruction of challenging defects around knee joint: distally based split vastus lateralis myocutaneous flap and review of literature

“…Well vascularised soft tissue coverage after adequate debridement of such defects would ensure wound healing and provide stable soft tissue cover. 2 Various alternatives are local cutaneous, muscle flaps and free tissue transfers. First introduced by Zhang, reverse flow ALT flap is a reliable, effective and durable option in such cases.…”