Abstract:

Objective    To investigate the anatomic features of the posterolateral thigh perforator and the clinical application of the free posterolateral thigh perforator flaps for repairing the soft tissue defect in extremities. Methods   Fresh lower limb specimens underwent an intraarterial injection of a lead oxide and red gelatin preparation. The integument of the thigh was dissected, and perforators of 0.5mm or more in the posterolateral thigh region were identified. Their origin, course, distributon, and  anastomosis were observed. The distribution features of skin and vessels in the posterolateral thigh region were documented by angiography and photography. Free posterolateral thigh perforator flaps were used in 6 patients with the soft tissue defects. The size of the defects ranged from 10cm×5cm to 16cm×7cm. Results   The perforating arteries from profunda femoris created cutaneous perforators in the posterolateral thigh. Their average external diameter was about 1.2±0.3mm. The average pedical length from the deep fascia was 6.1～14.3cm. Cutaneous perforators could be found on a line extending from the ischium to the lateral femoral condyle and constructed a vascular net aline the axis. All flaps survived after surgery with the donor sites healed by first intention. After following up for 6～12 months, the appearance and function of the flaps were all satisfactory with excellent texture. Conclusion   The free posterolateral thigh perforator flap is easy to perform with constant location and excellent texture. It can be a useful alternative to repair the soft tissue defect of the extremities.

Key words: Perforator flap； Profunda femoris artery； Posterolateral thigh region； Soft tissue defect； Anatomy