Gideroğlu Kaan, Cakici Hüsamettin, Yildirim Serkan, Yazar Sükrü, Aköz Tayfun
Department of Plastic and Reconstructive Surgery, Medical Faculty of Abant Izzet Baysal University, Bolu, Turkey.
Eklem Hastalik Cerrahisi. 2009;20(3):149-55.
The aim of this study was to evaluate the results of free anterolateral thigh (ALT) flap reconstruction for large and complex soft tissue defects of forearm and hand.
Thirteen patients (11 males, 2 females; mean age 32.5 years; range 18 to 55 years) underwent free ALT flap reconstruction for forearm and hand defects. The etiology of defects was crush injury in nine patients, tumor excision in two patients, electric burn in one patient, and unstable scar excision in one patient. In five patients a flow through ALT flap was used to reconstruct vascular defects. In tree patients a vascularised fascial ALT flap was used to reconstruct the tendon defects and in five patients neurosensory ALT flap was used. Patients were followed for 44+/-14.6 months. Chen classification was used to evaluate functional outcomes at the end of the postoperative first year.
All flaps survived completely in 11 patients. In the other two patients marginal necrosis was observed. These areas with necrosis healed after debridement and daily dressings. The functional results were satisfactory in 11 patients according to Chen classification (6 patients Chen I and 5 patients Chen II) and poor in two patients (Chen III).
The anterolateral thigh flap represents an excellent option for covering various complex defects in the forearm and hand. The flap provides a thin, pliable, vascularized tissue for covering the exposed tendons, nerves, bones, and reconstruct deficiencies.
本研究旨在评估游离股前外侧（ALT）皮瓣修复前臂和手部大面积复杂软组织缺损的效果。
13例患者（男11例，女2例；平均年龄32.5岁；年龄范围18至55岁）接受游离ALT皮瓣修复前臂和手部缺损。缺损病因包括挤压伤9例、肿瘤切除2例、电击伤1例、不稳定瘢痕切除1例。5例患者采用穿支ALT皮瓣修复血管缺损。3例患者采用带血管蒂筋膜ALT皮瓣修复肌腱缺损，5例患者采用感觉神经ALT皮瓣。对患者进行了44±14.6个月的随访。术后第1年末采用陈式分类法评估功能结果。
11例患者的所有皮瓣完全存活。另外2例患者出现边缘坏死。经清创和每日换药后，这些坏死区域愈合。根据陈式分类法，11例患者功能结果满意（陈I级6例，陈II级5例），2例患者功能结果差（陈III级）。
股前外侧皮瓣是修复前臂和手部各种复杂缺损的理想选择。该皮瓣提供了一种薄而柔韧的带血管组织，用于覆盖外露的肌腱、神经、骨骼并修复缺损。
