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The composite anterolateral thigh flap for knee extensor and skin reconstruction
Authors:Seung Han Song  Sangmun Choi  Young-Mo Kim  Seung Ryul Lee  Young Woong Choi  Sang-Ha Oh
Institution:1. Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, 640 Daesa-dong, Daejeon, Jung-gu, 301-721, South Korea
2. Department of Orthopedic Surgery, Chungnam National University Hospital, Daejeon, South Korea
3. Department of Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, South Korea
4. PLUS Aesthetic Clinic, Daejeon, South Korea
6. Department of Plastic and Reconstructive Surgery, Sanggye Piak Hospital, School of Medicine, Inje University, Seoul, South Korea
5. Clinical Anatomy Institute, Chungnam National University Hospital, Daejeon, South Korea
Abstract:The simultaneous reconstruction of a skin defect and lost extensor mechanism of the knee joint is difficult. We present a 31-year-old male who lost the patella and had a 9 × 10 cm skin defect after a total patellectomy for an infected open patellar fracture. A composite anterolateral thigh (ALT) flap including vascularized skin and fascia lata (FL) was elevated. The FL was folded and sutured to the remaining patellar tendon. The skin flap covered the skin defect. The wound healed uneventfully. Thirty months later, the active range of motion of the knee joint was 0°–120° and the extension strength of the knee joint was normal. He could stand on his right leg and walk without assistance. The composite ALT flap is a valuable option in knee reconstruction after a total patellectomy.
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