Li Shanshan, Liu Yuanbo, Zang Mengqing, Yu Shengji, Guo Wei, Yang Rongli
Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
J Plast Reconstr Aesthet Surg. 2018 Feb;71(2):232-238. doi: 10.1016/j.bjps.2017.10.017. Epub 2017 Nov 2.
Successful raising of a distally based anterolateral thigh (dALT) flap mainly depends on a well-developed lateral circumflex femoral artery (LCFA) descending branch and an intact vascular connection between the descending branch and the vascular network of the knee. However, in some clinical scenarios, the descending branch is hypoplastic or the vascular connection of the knee is compromised. We present six cases of using dALT flaps in soft tissue defect reconstruction of the knee with either of the above-mentioned conditions. In these cases, the flaps relied on the reverse blood flow through the rectus femoris branch and showed complete survival postoperatively. We believe that the reverse flow from the rectus femoris branch could be an alternative blood supply for the dALT flap in the presence of hypoplasia of the LCFA descending branch or compromise of the vascular connection between the descending branch and the articular geniculate network.
以股外侧肌远端为蒂的股前外侧皮瓣（dALT）的成功切取主要取决于发育良好的旋股外侧动脉（LCFA）降支以及降支与膝关节血管网之间完整的血管连接。然而，在某些临床情况下，降支发育不良或膝关节的血管连接受损。我们报告了6例在上述任何一种情况下使用dALT皮瓣进行膝关节软组织缺损重建的病例。在这些病例中，皮瓣依靠股直肌支的逆向血流，术后显示完全存活。我们认为，在LCFA降支发育不良或降支与膝部膝状血管网之间的血管连接受损的情况下，股直肌支的逆向血流可能是dALT皮瓣的一种替代血供。
