Pedicled anterolateral thigh myocutaneous flap for repair of large skin defects surrounding the knee joint and proximal calf

Li Zhongwen; Xu Shuailing; Wu Xinju; Zhu Ziqiang

doi:10.3969/j.issn.1009-4237.2025.02.008

Abstract：Objective To explore the clinical effect of pedicled anterolateral thigh myocutaneous flap in retrograde repair of large skin defects surrounding the knee joint and proximal calf.Methods From Jan.2018 to Dec.2022,8 such patients(6 males and 2 females,aged 30-58 years,with an average of 50.1 years)who were trea-ted in our department were retrospectively analyzed.There were 6 road traffic accidents and 2 others.The skin defect was minimally 110 mm×60 mm and maximally 340 mm×140 mm,with the flap being 130 mm×70 mm and 360 mm×160 mm.The donor site was directly sutured or repaired by skin transplantation or with inguinal flap or other local flaps.After surgery,the wound healing and survival of the flap were observed,and regular follow-up was conducted to assess the appearance,texture,and color of the flap,as well as knee functions.Results All the myo-cutaneous flaps survived.Among them,2 cases had partial necrosis in the distal end(20 mm×30 mm),which healed smoothly after dressing change.Patients were followed up for 3-12 months,with an average of 8.2 months.The cov-erage area of the wound was increased by about 30%after tiling the lateral femoral muscle and skin flap.At the same time,the partial fascia lata was used to reconstruct the knee ligament at an early stage.For all the patients,the knee joint function recovered well:flexion and extension range of mobility being 20°-100°,and internal and external rotation being 10°-20°.At the last follow-up,the flap was slightly bloated with a similar color to the recipient and soft texture;for the donor site,there was no movement dysfunction.Conclusion Retrograde coverage of large skin defects around the knee joint and the proximal calf by using pedicled anterolateral thigh myocutaneous flap has the characteristics of maximizing the effective repair area and promoting the early recovery of knee joint function.The clinical effect is satisfactory and worth popularization.