Vascular anatomy of the anteromedial thigh flap
Introduction: The anteromedial thigh flap (AMT) lies adjacent to the anterolateral thigh flap (ALT) area and can be used as a backup whenever the ALT is not feasible. Literature published on the AMT flap is limited, and the vascular anatomy of the AMT flap is not well understood. Clarification of th...
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doaj-7adc713936374e35a6fe1503c6db8a862020-11-24T23:48:17ZengElsevierJPRAS Open2352-58782017-09-0113C11312510.1016/j.jpra.2017.05.008Vascular anatomy of the anteromedial thigh flapJeremy Mingfa Sun0Khong Yik Chew1Chin Ho Wong2Terence Lin Hon Goh3Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, SingaporeDepartment of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Outram Road, 169608, SingaporeDepartment of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Outram Road, 169608, SingaporeDepartment of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Outram Road, 169608, SingaporeIntroduction: The anteromedial thigh flap (AMT) lies adjacent to the anterolateral thigh flap (ALT) area and can be used as a backup whenever the ALT is not feasible. Literature published on the AMT flap is limited, and the vascular anatomy of the AMT flap is not well understood. Clarification of the vascular anatomy will be useful for safe and efficient planning and raising of the AMT flap. Method: Fourteen cadaveric lower limbs were injected with latex dye and dissected to study the skin perforators larger than 0.5 mm in the anterolateral and anteromedial thigh. We demonstrate the application of the AMT flap in a clinical case where a combined ALT and AMT flap was used to reconstruct a tongue and floor of mouth defect post cancer resection. Results: Perforators that supplied the rectus femoris muscle and the overlying skin were present in all specimens and 12/14 (85.7%) specimens had rectus femoris branches (RFBs) originating from the descending branch of the lateral circumflex iliac artery. In total, 82.4% of AMT perforators are musculocutaneous (14/17 specimens), and they pierce the muscular fascia along a line drawn from the mid-inguinal point to the superomedial pole of the patella. The perforators congregate at the one-quarter mark and the midpoint of this line. This line is useful for the preoperative planning of the AMT flap. Conclusion: The anatomy of the RFB, which is critical in the blood supply of the AMT flap, is constant and predictable. The location of the perforators is predictable, which aids preoperative planning.http://www.sciencedirect.com/science/article/pii/S2352587817300396Anteromedial thigh flapAnterolateral thigh flapRectus femorisMedial thigh flapRectus femoris branch |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jeremy Mingfa Sun Khong Yik Chew Chin Ho Wong Terence Lin Hon Goh |
spellingShingle |
Jeremy Mingfa Sun Khong Yik Chew Chin Ho Wong Terence Lin Hon Goh Vascular anatomy of the anteromedial thigh flap JPRAS Open Anteromedial thigh flap Anterolateral thigh flap Rectus femoris Medial thigh flap Rectus femoris branch |
author_facet |
Jeremy Mingfa Sun Khong Yik Chew Chin Ho Wong Terence Lin Hon Goh |
author_sort |
Jeremy Mingfa Sun |
title |
Vascular anatomy of the anteromedial thigh flap |
title_short |
Vascular anatomy of the anteromedial thigh flap |
title_full |
Vascular anatomy of the anteromedial thigh flap |
title_fullStr |
Vascular anatomy of the anteromedial thigh flap |
title_full_unstemmed |
Vascular anatomy of the anteromedial thigh flap |
title_sort |
vascular anatomy of the anteromedial thigh flap |
publisher |
Elsevier |
series |
JPRAS Open |
issn |
2352-5878 |
publishDate |
2017-09-01 |
description |
Introduction: The anteromedial thigh flap (AMT) lies adjacent to the anterolateral thigh flap (ALT) area and can be used as a backup whenever the ALT is not feasible. Literature published on the AMT flap is limited, and the vascular anatomy of the AMT flap is not well understood. Clarification of the vascular anatomy will be useful for safe and efficient planning and raising of the AMT flap.
Method: Fourteen cadaveric lower limbs were injected with latex dye and dissected to study the skin perforators larger than 0.5 mm in the anterolateral and anteromedial thigh. We demonstrate the application of the AMT flap in a clinical case where a combined ALT and AMT flap was used to reconstruct a tongue and floor of mouth defect post cancer resection.
Results: Perforators that supplied the rectus femoris muscle and the overlying skin were present in all specimens and 12/14 (85.7%) specimens had rectus femoris branches (RFBs) originating from the descending branch of the lateral circumflex iliac artery. In total, 82.4% of AMT perforators are musculocutaneous (14/17 specimens), and they pierce the muscular fascia along a line drawn from the mid-inguinal point to the superomedial pole of the patella. The perforators congregate at the one-quarter mark and the midpoint of this line. This line is useful for the preoperative planning of the AMT flap.
Conclusion: The anatomy of the RFB, which is critical in the blood supply of the AMT flap, is constant and predictable. The location of the perforators is predictable, which aids preoperative planning. |
topic |
Anteromedial thigh flap Anterolateral thigh flap Rectus femoris Medial thigh flap Rectus femoris branch |
url |
http://www.sciencedirect.com/science/article/pii/S2352587817300396 |
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