Ao M, Nagase Y, Mae O, Namba Y
Department of Plastic and Reconstructive Surgery, Okayama Saiseikai General Hospital, Japan.
Ann Plast Surg. 1997 Jun;38(6):598-603. doi: 10.1097/00000637-199706000-00006.
Massive posttraumatic defects of the foot in 4 patients and a tibial malunion in another were repaired by flow-through anterior (anterolateral and anteromedial) thigh flaps. Posterior tibial vessels were used as the recipient vessel just below the level of the medial malleolus. Soft-tissue defects in foot-injured patients were covered with flow-through anterior thigh flaps interposing the descending branch of the lateral circumflex femoral system between the transected posterior tibial vessels. In another patient, a combined anteromedial thigh flap and vascularized iliac bone cross-leg "chimeric" flap were successfully transferred for the reconstruction of a malunion of a tibial fracture, which had been accompanied by severe vascular damage to the thigh. The utilization of derivative branches from the lateral circumflex femoral system facilitates revascularization of ischemic areas and simultaneous transplantation of multiple components, as well as preserves recipient vessels. Owing to the stable blood supply, these flaps can be readily processed into both deepithelialized and thin flaps.
4例足部严重创伤后缺损患者和另1例胫骨骨不连患者采用穿支股前（股前外侧和股前内侧）皮瓣修复。在内踝水平以下，将胫后血管用作受区血管。足部受伤患者的软组织缺损采用穿支股前皮瓣覆盖，将旋股外侧系统的降支置于横断的胫后血管之间。在另1例患者中，成功转移了股前内侧皮瓣和带血管蒂的髂骨交叉腿“嵌合”皮瓣，用于重建伴有大腿严重血管损伤的胫骨骨折骨不连。利用旋股外侧系统的分支有助于缺血区域的再血管化和多个组织成分的同时移植，还能保留受区血管。由于血供稳定，这些皮瓣可很容易地制成去上皮薄皮瓣。
