Qin Xiabing, Hu Zhengyi, Ou Qifeng
Department of Hand Surgery, Shiyan Taihe Hospital Affiliated to Hubei University of Medicine, No. 32, South Renmin Road (at Renmin Middle Road), Maojian District, Shiyan, Hubei Province 442005, China.
Regenerative Medicine Institute (REMEDI) at CÚRAM SFI Research Centre for Medical Devices, School of Medicine, College of Medicine, Nursing and Health Sciences, University of Galway, Galway City, Galway County, H91 W2TY, Ireland.
J Surg Case Rep. 2025 Jul 24;2025(7):rjaf538. doi: 10.1093/jscr/rjaf538. eCollection 2025 Jul.
This study investigates the outcomes of double-paddle anterolateral thigh (ALT) perforator flaps in repairing hand and foot wounds, with emphasis on intraoperative vascular variations. Between April 2019 and April 2021, 10 cases with large defects were planned to be treated using double-paddle ALT flaps based on two descending branches of the lateral circumflex femoral artery (DB-LCFA). In three cases, one perforator arose from an atypical source, and in one case, both skin paddles traced back to a single perforator bifurcating near the skin. All flaps survived, except for one partial necrosis and one intraoperative perforator injury. Most donor sites were closed primarily; two required additional coverage. Follow-up (3-15 months) showed good functional and aesthetic recovery. These results support the double-paddle ALT flap as a viable reconstructive option. However, anatomical variations demand intraoperative adaptability, and when long pedicles are required, converting to two independent flaps may offer better reliability.
本研究探讨双叶股前外侧（ALT）穿支皮瓣修复手足创面的效果，重点关注术中血管变异情况。2019年4月至2021年4月期间，计划对10例存在大面积缺损的病例采用基于旋股外侧动脉降支（DB-LCFA）两个分支的双叶ALT皮瓣进行治疗。3例中，有1个穿支起源于非典型部位，1例中，两个皮瓣均追溯至在皮肤附近分叉的单个穿支。除1例部分坏死和1例术中穿支损伤外，所有皮瓣均存活。多数供区可直接缝合；2个供区需要额外的覆盖物。随访（3 - 15个月）显示功能和美观恢复良好。这些结果支持双叶ALT皮瓣作为一种可行的重建选择。然而，解剖变异需要术中的适应性，当需要长蒂时，转换为两个独立皮瓣可能会提供更好的可靠性。
