Rectus femoris branch: an alternative blood supply for a distally based anterolateral thigh flap

Publication date: Available online 1 November 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Shanshan Li, Yuanbo Liu, Mengqing Zang, Shengji Yu, Wei Guo, Rongli Yang
Successful raising of a distally-based anterolateral thigh (dALT) flap mainly depends on a well-developed lateral circumflex femoral artery (LCFA) descending branch and an intact vascular connection between the descending branch and the vascular network of the knee. However, in some clinical scenarios, the descending branch is hypoplastic or the vascular connection of the knee is compromised. We present six cases of using dALT flaps in soft tissue defect reconstruction of the knee with either of the above-mentioned conditions. In these cases, the flaps relied on the reverse blood flow through the rectus femoris branch and showed complete survival postoperatively. We believe the reverse flow from the rectus femoris branch could be an alternative blood supply for the dALT flap in the presence of hypoplasia of the LCFA descending branch or compromise of the vascular connection between the descending branch and the articular geniculate network.