Application of anterolateral thigh flow-through flap in limb salvage treatment for patients with severe limb injuries
Li Gang
Fan Xinyu
Xu Yongqing
Su Yongyue
Liu Xingqiang
Yu Wei
Abstract：Objective To investigate the clinical application of flow-through anterolateral thigh flap(AL-TF)and its limb salvage value in the treatment of severe limb injuries.Methods From Jun.2022 to Dec.2024,12 patients with severe limb injuries(4 upper limb and 8 lower limb,9 male and 3 female)treated with flow-through ALTF were retrospectively analyzed.The age of the patients ranged from 6 to 57 years,with an average age of 29.3 years.The injury causes included blast in 1 case,rolling and cutting by agricultural machines in 3 cases,hit by heavy objects in 2 cases,and road traffic accidents in 6 cases.The length of the vascular defect was 5-10 cm,and the length of the bone defect was 2-9 cm,with the soft tissue defects being 10 cm×7 cm to 20 cm×6 cm.Ten cases were repaired in one stage and 2 cases in the second stage.The size of the flaps ranged from 11 cm×8 cm to 21 cm×7 cm.All patients were followed up at the outpatient clinic after operation,assessing the appearance and texture of the flap and limb,the fracture healing,and the function of the affected limb.Results Patients were followed up for 12-24 months(average 15.1 months).The flaps and limbs of all 12 patients survived,and the limb salvage was successful.Vascular crisis occurred in 2 cases at 1 d after operation,which was resolved following exploration and treatment.At two months after bone grafting and internal fixation,one patient experienced internal fixation breakage due to premature weight-bearing,which healed after re-surgery.The excellent and good rate of lower limb function was 87.5%by Johner-Wrush score,and 75.0%of upper limb function by Berton score.Conclusion The flow-through ALTF can simultaneously repair the soft tissue and vascular defects in patients with severe limb injuries.It has the advantages of reliable blood supply,high survival rate,and good functional recovery,and is an effective meth-od for limb salvage treatment.
Keywords：Severe limb injuriesFlow-through flap anterolateral thighVascular graftingLimb Salvage
Publication Date：2025-09-15
Online Publishing Date：2025-09-28(First online date of this platform, not the publication date of the document)
Pages：5( 666-670 )