Abstract:

Objective

To investigate the clinical effect of free anteriolateral thigh perforator flap with fascia lata to repair the complex soft tissue defect of foot and ankle.

Methods

From January 2017 to January 2022，the anterolateral femoral perforator flap wih fascia lata was used to repair the sof tissue defect in 15 cases of foot and ankle injury in Foshan Gaoming District People's Hospital . The soft tissue defect area was （5.0×7.0） cm² to （9.5×15.0） cm². After discharge，the patients were followed up in outpatient clinic or wechat， including the appearance color， sensation of the flap， functional recovery of the foot and ankle and the donor site.

Results

All 15 cases of free anteriolateral thigh perforator flaps survived， two cases of flaps were found vascular crisis 48 h after operation， the flaps suvived after emergency investigation. All the cases were followed up for 10 to 18 months， with an average follow-up time of （12.0±0.6） months. 10 cases were followed up in outpatient department and five cases were followed up on Wechat. The 15 cases had good appearance， no obvious pigmentation soft texture of the flap， nor influence on ankle joint movement .The two-point resolution of the flap was nine to 12 mm， with an average of （9.00±0.20） mm. According to the AOFAS ankle-hind foot score， 10 cases were excellent and five cases were good. The donor site of the skin flap healed well， 13 cases of the donor area were sutured linearly， two cases of the donor area could not be sutured directly， and the donor site healed after free skin graft ，there was no obvious muscle loss in the thigh of the donorsite.

Conclusion

Free anteriolateral thigh perforator flap with fascia lata can be transplanted to repair the complex tissue defect of foot and ankle， the flap can be cut with large area， flexible texture， early functional exercise good ankle function recovery， little damage in the donor site， and suitable for clinical.

Key words: Surgical flaps, Ankle jont, Free tissue flaps, Microsurgery