PURPOSE: The anterolateral thigh flap has many advantages over other conventional free flaps. But the anterolateral thigh flap has yet to enter widespread use because perforating arteries exhibit a wide range of anatomic variations and are difficult to dissect when small. The aim of this study is to identify the vascular variability of perforating arteries and pedicle in the anterolateral thigh free flap. METHODS: We studied 12 cadavers and dissected 23 thighs. An anterolateral thigh flap (12x12cm) was designed and centered at the midpoint of the line drawn from anterior superior iliac spine to the superolateral border of the patella. After we identifed the perforating arteries we dissected up to their origin from lateral circumflex femoral artery along descending branch of lateral circumflex femoral artery. We then investigated the number and the position of perforating arteries, length and diameter of vascular pedicle and pattern of lateral circumflex femoral arterial system. RESULTS: On average 2.3+/-1.1 perforating arteries per thigh were identified. The musculocutaneous perforators were 63.1%. In those perforators five perforators were arose from transverse branch of lateral circumflex femoral artery and two were arose from rectus femoral artery. Most of the perforators were near the intermuscular septum between rectus femoris muscle and vastus lateralis muscle. The length and diameter of pedicle were 11.9+/-3.5cm and 3.1+/-0.8mm on average. CONCLUSION: This study will be helpful for the success in anterolateral thigh free flap.
Anatomy, Regional ; Arteries ; Cadaver ; Femoral Artery ; Free Tissue Flaps ; Muscles ; Patella ; Quadriceps Muscle ; Spine ; Thigh

Strength training is one of the most common exercises practiced in the field of physical therapy or sports training. However, limited methodology is available to evaluate its effect on the target muscle. This study aimed to test the hypothesis that surface electromyographic (EMG) data from both isometric and isotonic exercise can express changes within the muscle during a 12-week strength training program. Ten healthy male volunteer students (5 for training, 5 for controls) from Yonsei University were recruited for evaluation in this study. DeLorme's axiom was practiced for 12 weeks in the dominant elbow flexors and knee extensors of the training group. Tension for 1 repetition maximum and maximal voluntary isometric contraction, and surface EMG information such as the integrated EMG and three variables from the regression line of median frequency (MDF) data were measured at weeks 0, 3, 6, 9, and 12. The limb circumference was measured at weeks 0 and 12. During the strength training, which was enough for the increment of muscle strength and limb circumference, the rectified-integrated EMG and initial MDF increased with a significant linear pattern in both types of contraction. The two surface EMG variables were able to monitor the physiologic muscle changes during the training. Based on these results, we propose that these two surface EMG variables can be used for monitoring electrophysiological changes in the specific muscle that is undergoing the training program, under conditions where the contraction mode for EMG data collection is either static or dynamic.
Quadriceps Muscle/anatomy & histology/physiology ; Muscle, Skeletal/anatomy & histology/physiology ; Male ; Isotonic Contraction/physiology ; Isometric Contraction/physiology ; Humans ; Fourier Analysis ; Exercise Therapy/*methods ; Electromyography/*methods ; Body Weights and Measures ; Adult