Clin Orthop Surg.  2017 Sep;9(3):348-354. 10.4055/cios.2017.9.3.348.

Differences between the Upper Extremity and the Lower Extremity in Reconstruction Using an Anterolateral Thigh Perforator Flap

Affiliations
  • 1Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea. handsurgeon@naver.com

Abstract

BACKGROUND
While reconstruction of soft tissue defects is the common purpose, surgical reconstructions of upper extremities and lower extremities have different goals in terms of functional and aesthetic outcomes. The purpose of the current study was to compare and analyze differences between reconstructions of upper extremities and lower extremities using an anterolateral thigh (ALT) flap.
METHODS
We analyzed 74 patients who underwent reconstructions of upper extremities and lower extremities using an ALT flap from October 2006 to August 2012 (upper extremities, 45 cases; lower extremities, 29 cases). The study focused on the statistical analysis of patient satisfaction according to the donor site of the ALT flap and the timing of a debulking procedure.
RESULTS
On the choice of donor site, in the upper extremity reconstruction, flap elevation from the opposite side of the recipient limb was preferred (p = 0.019) because it causes less inconvenience while walking. In the lower extremity reconstruction, flap elevation from the same side of the recipient limb (p = 0.002) was preferred. The debulking procedure performed on the upper extremities at 4 weeks after reconstruction led to better functional results and enhanced patient satisfaction (p = 0.022). In the case of lower extremities, enhanced satisfaction was noted in patients who underwent the procedure at 6 months after reconstruction (p < 0.001).
CONCLUSIONS
Elevation of the flap in reconstruction reduced inconvenience when performed on the same side of the recipient limb for lower extremities and on the opposite side for upper extremities. In addition, debulking resulted in better satisfaction when performed 4 weeks postoperatively in the upper extremities and 6 months postoperatively in the lower extremities.

Keyword

Upper extremity and lower extremity; Debulking; Anterolateral thigh flap

MeSH Terms

Arm/*surgery
Arm Injuries/etiology/surgery
Humans
Leg/*surgery
Leg Injuries/etiology/surgery
Operative Time
Patient Satisfaction
Perforator Flap/*surgery
Reconstructive Surgical Procedures/*methods
Thigh/*surgery
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