Summary
Background
The leg and peripatellar region have always been known as a poor source of available
flaps. One flap donor site that has proven to be adequate is the distal anteromedial
half of the thigh. Due to the potential and plentiful vascular sources of this anatomic
region we decided to study the distal anteromedial thigh and its clinical applications.
Anatomic study
Sixteen cryopreserved inferior limbs were latex-injected in the femoral artery and
the skin perforators of the distal anteromedial thigh and their source vessels were
studied.
Clinical study
In a period between December 2000 and June 2005, skin islands from the distal anteromedial
aspect of the thigh of six patients were transferred, as local perforator flaps, to
reconstruct the peripatellar region and upper leg soft tissue defects. Every flap
was based on a single adequate perforator vessel. The tissue was rotated, as a ‘propeller’,
through 180° and the flap was named ‘the propeller distal anteromedial thigh perforator
flap’.
Results
In the distal anteromedial thigh the anatomic variability includes not only perforator
vessels but also their source vessels. Skin perforators can come from each of the
deep vessels.
Our clinical results, with a follow up of 1–4 years, show no total flap losses. Partial
necrosis>20% happened in one diabetic patient.
Conclusion
The propeller distal anteromedial thigh perforator flap can be reliably transferred
based on only one adequate perforator vessel. It reduces the morbidity and improves
the availability of the distal anteromedial thigh as a flap donor site and represents
an additional reconstructive option for knee and upper leg defects.
Keywords
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Article info
Publication history
Published online: May 14, 2007
Accepted:
February 26,
2007
Received:
August 3,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
