Abstract:
The anterolateral thigh (ALT) flap has become one of the workhorse flaps, with indications including diverse reconstructive problems. The lateral thigh area is also a useful donor site for nerve grafts. The lateral femoral cutaneous (LFC) nerve can be dissected along with the ALT flap for a substantial length, depending on the requirements of the recipient site. The LFC nerve can be used as a vascularized or non-vascularized nerve graft. The technique offers advantages and it can find clinical applications, satisfying the functional and aesthetic reconstructive requirements of a complex defect. We report the case of a patient who presented with traumatic soft tissue defect of the volar aspect of the wrist and ulnar nerve defect as a complication of a fracture of distal radius. An ALT flap was used to reconstruct the soft tissue defect. The ulnar nerve was resected due to necrosis and the gap was repaired with non-vascularized grafts of the anterior branch of the LFC nerve. The soft tissues were resurfaced successfully without complications. Functional recovery was good for the superficial branch of the ulnar nerve, whereas it was variable for the deep branch of the ulnar nerve. The anterolateral thigh area offers significant advantages as donor site in the reconstruction of complex soft tissue defects being a large source of vascularized skin, fat, fascia, muscle and nerve. This availability allows for single donor site dissection, minimizing the operating time and the associated morbidity.
摘要:
股前外侧(ALT)皮瓣已成为主力皮瓣之一,适应症包括各种重建问题。大腿外侧区域也是神经移植物的有用供体部位。股外侧皮(LFC)神经可以与ALT皮瓣一起解剖相当长的长度,根据收件人网站的要求。LFC神经可用作血管化或非血管化神经移植物。该技术具有优势,可以找到临床应用,满足复杂缺陷的功能和美学重建要求。我们报告了一例患者,该患者表现为腕部掌侧的创伤性软组织缺损和尺神经缺损,这是桡骨远端骨折的并发症。使用ALT皮瓣重建软组织缺损。由于坏死而切除了尺神经,并用LFC神经前支的非血管化移植物修复了间隙。成功修复软组织,无并发症。尺神经浅支功能恢复良好,而对于尺神经的深支来说,它是可变的。股前外侧区域作为重建复杂软组织缺损的供体部位提供了显着的优势,是血管化皮肤的重要来源。脂肪,筋膜,肌肉和神经。这种可用性允许单个供体部位解剖,尽量减少手术时间和相关的发病率。