Because of minimal donor site morbidity, adequate tissue, excellent clinical and functional results, the anterolateral thigh flap has become one of the most important tissue flaps which are used to repair the defects of head and neck. Generally, anterolateral thigh flap is mainly used to repair the maxillofacial defects in head and neck surgery. However, the anterolateral thigh flap is a better tissue flap for reconstruction of hypopharyngeal and cervical esophageal defects.
Esophagus ; surgery ; Head ; surgery ; Humans ; Hypopharynx ; surgery ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thigh

A low grade fibromyxoid sarcoma is a rare soft tissue tumor that has a tendency to develop in the deep soft tissue of young adults and the potential for local recurrence or distant metastasis. There have been several case reports and sporadic reports in the literature. However, only 1 case has been reported in Korea but without a follow-up result. We describe a 54-year-old female patient with a low-grade fibromyxoid sarcoma of the thigh that had been growing slowly for 34 years. A marginal resection of this tumor was performed. Currently, the patient is doing well without evidence of local recurrence or distant metastasis at 5 years after surgery.
Female ; Fibrosarcoma/*pathology/surgery ; Humans ; Middle Aged ; Soft Tissue Neoplasms/*pathology/surgery ; Thigh/*pathology/surgery

OBJECTIVETo investigate clinical curative effects of gluteal muscle contracture release combined with insertion of gluteus maximus tendo-chilles lengthening with Z-shaped in treating severe gluteal muscles contracture.

METHODSFrom 2006 May to 2011 May, 20 patients (35 sides) with severe gluteal muscle contracture were collected, including 12 males and 8 females, aged from 8 to 34 years old with an average of 13 years old; the courses of disease ranged from 3 to 21 years. All patients manifested abnormal gait at different degree, knees close together cannot squat,positive syndrome of Ober, positive test of alice leg. Gluteus contracture fascia release were performed firstly in operation, then insertion of tendo-chilles lengthening with Z-shaped were carried out. Preoperative and postoperative gait, and knee flexion hip extensor squat test, cross leg test, adduction and internal rotary activity of hip joint, stretch strength and motor ability after hip abduction were observed and compared.

RESULTSTwenty patients were followed up for 1 to 5 years. Gluteus maximus were released thoroughly, and snapping hip was disappeared, Ober syndrome were negative. There was significant differences in knee flexion hip extensor squat test, adduction and internal rotary activity of hip joint,stretch before and after operation (P<0.01). Gluteus muscle strength was protected,stretch strength and motor ability of hip joint were recovered well. Among them,31 cases got excellent results and 4 good.

CONCLUSIONFor severe gluteal muscles contracture,insertion of gluteus maximus tendo-chilles lengthening with Z-shaped performed after gluteus contracture fascia release could release gluteal muscle contracture to the greatest extent and obtain postoperative curative effect without resection of normal hip muscle fibers and destroy joint capsule.

Adolescent ; Adult ; Buttocks ; surgery ; Child ; Contracture ; surgery ; Female ; Hip ; surgery ; Humans ; Male ; Muscle, Skeletal ; surgery ; Thigh ; surgery ; Young Adult

OBJECTIVETo summarize the anatomic characteristic of sigle pedicled double island free anterolateral thigh flaps and to evaluate its application and classification.

METHODSBetween January 2010 and March 2013, 76 patients underwent free femoral anterolateral double island flap reconstruction of the defects in oral and maxillofacial region. Summarized the anatomic features of perforators, such as the number and origin of the perforators.

RESULTSAccording to the anatomic features and regularity of perforators, 76 cases of femoral anterolateral double island flaps were divided into 3 types: trunk type (type I), 15 cases (20%), in which the perforators of two flaps originated in descending branch and transverse branch of lateral femoral circumflex artery respectively; branch type (type II), 55 cases (72%), in which both the perforators originated in lateral femoral circumflex artery descending branch or lateral femoral circumflex artery transverse branch; bifurcation type (type III), 6 cases (8% ), in which two perforators originated in the two bifurcation of one perforator. Among the 76 cases, 75 survived and 1 showed partial necrosis.

CONCLUSIONSAccording to the anatomic features and regularity of perforators, femoral anterolateral double island flaps can be divided into 3 types: trunk type (I type), branch type (II type), bifurcation type (III type).

Face ; surgery ; Femoral Artery ; Humans ; Mouth ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thigh

Anterolateral thigh flap is perfect for reconstructing maxillofacial soft tissue defects. This tissue has been widely used by clinicians, but often causes operation difficulties because of vascular variation. In this paper, we report a case where anteromedial thigh was used as new donor site when the vascular anatomic variation of anterolateral thigh perforator flap induced a failure in the flap harvest. Moreover, this paper discusses the anatomy and application of anteromedial thigh flap.
Humans ; Maxillofacial Abnormalities ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; methods ; Thigh ; surgery

OBJECTIVETo investigate the feasibility of one-stage phallic reconstruction with the extended pudendal-thigh flap (EPTF) to achieve a higher survival rate, shorter surgical cycle, and more experimental evidence for the clinical application of the technique.

METHODSWe equally randomized 36 healthy adult New Zealand rabbits to an experimental and a control group to receive one-stage phallic reconstruction, the former with EPTF (pudendal-thigh flap + thigh cutaneous branches of the superficial external pudendal artery, PTF + TCB), the urethra reconstructed with the TCB flap, and the latter with bilateral pudendal-thigh flaps.

RESULTSThe survival rate of the reconstructed phallus was 83.33% (15/18) and the urine leakage was 55.56% (10/18) in the experimental group, as compared with 38.89% (7/18) and 72.22% (13/18) in the controls.

CONCLUSIONOne-stage phallic reconstruction with EPTF, with its higher survival rate and shorter surgical cycle, is a desirable substitute for phallic reconstruction with bilateral pudendal-thigh flaps.

Animals ; Male ; Penis ; surgery ; Rabbits ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Thigh ; surgery

OBJECTIVETo study the short-term results and technological improvement of free anterolateral thigh (ALT) flaps in the reconstruction of circumferential hypopharyngeal defects.

METHODSThe free ALT flap with a reporter skin paddle was used in 22 cases with circumferential hypopharyngeal defects. The short-term results of reconstructive surgeries and key points, advantages and complications of this technique were summarized.

RESULTSThe length of circumferential hypopharyngeal defects ranged from 7 to 9 cm. ALT flap with an area of (8-9) cm × (11-18) cm was harvested. A reporter skin island with the skin area of (2.0-3.0) cm × (2.5-4.0) cm was designed. 91% (20/22) of ALT flaps survived. Two cases with flap necrosis underwent second reconstruction with a pedicled pectoralis major flap. All the patients had patent anastomotic lumen. Good postoperative subjective swallowing evaluation was obtained in 59% (13/22) of patients; 41% (9/22) of patients had acceptable swallowing results. Three patients (14%) presented with postoperative pharyngocutaneous fistula. One case recovered spontaneously in short-term and other two cases received the second reconstructive surgery.

CONCLUSIONSThe application of free ALT flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defect is technologically easy and reliable, with satisfying swallowing function and limited trauma.

Free Tissue Flaps ; Humans ; Hypopharynx ; pathology ; surgery ; Pharyngeal Diseases ; surgery ; Reconstructive Surgical Procedures ; Skin Transplantation ; Thigh

OBJECTIVETo explore the optimal methods for the reconstruction and preservation of the glans after partial penis resection in the treatment of early-stage penile cancer.

METHODSBetween January 2012 and June 2015, we treated 6 cases of early- stage penile cancer by partial penis resection, inner thigh skin graft, and glans reconstruction and followed them up for 0.5-3 years.

RESULTSThe length of the penis before and after operation was ([6.5 ± 1.2] vs [4.5 ± 1.8] cm) in the flaccid state and ([12.8 ± 2.3] vs [9.1 ± 2.1] cm) in the erectile state. The sense of the reconstructed glans was completely recovered at 3 months after surgery. The glans skin was pale red and soft, nearly normal at 12 months, with no obvious graft contracture or scar formation. All the patients achieved normal erection and their partners were satisfied with their intercourse. No recurrence or metastasis was observed.

CONCLUSIONThe strategy of partial penis resection, inner thigh skin graft and glans reconstruction, simple, effective, and with few complications, is one of the best treatments of early-stage penile cancer, which not only ensures radical removal of the tumor but also maximally reserves the function of the organ.

Humans ; Male ; Penile Neoplasms ; surgery ; Penis ; surgery ; Reconstructive Surgical Procedures ; Skin Transplantation ; Thigh

A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cm multiply 4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap's vascular pedicle. A split thickness free skin graft was used to cover the muscle flap and around the flap's vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap survived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This technique can be used to preserve the flow and patency of recipient arteries.
Humans ; Leg ; Leg Injuries ; surgery ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Thigh

Aged ; Carcinoma, Merkel Cell ; diagnosis ; surgery ; Female ; Humans ; Skin Neoplasms ; diagnosis ; surgery ; Thigh