Barragán-Cabral J, Morales-González JA, Rodríguez-Salazar TL, Barragán-García JM

Language: Spanish
References: 5
Page: 33-36
PDF size: 265.21 Kb.

ABSTRACT

The system of the lateral femoral circumflex artery in the thigh has allowed the flaps development of the tensor fasciae latae and the anterolateral thigh flap. The latter is composed of skin and subcutaneous adipose tissue of the anterolateral side of the thigh. The flap can provide an extensive cutaneous area with a dimension of up to 25 for 35 centimeters. We show the case of a 30-year-old man who suffered a road accident presenting severe crushing injury in the distal third of the left lower limb, undergoing amputation in Lisfranc-type rear foot by the trauma service, evolving with necrosis and infection of the skin flap. Assessed by the Plastic Surgery Service and as a salvage measure, it was decided to perform debridement, negative pressure therapy and once suitable granulation tissue was developed, anterolateral flap of the sensory thigh was performed incorporating the anterior branch of the lateral femoral cutaneous nerve with end-lateral anastomosis of the perforator of the lateral circumflex femoral artery under microscope, having as a recipient vessel the distal third of the posterior tibial artery and a termino-terminal epi-perineural neurorrhaphy of the lateral cutaneous femoral nerve to the sural nerve. The post-surgical evolution was satisfactory, achieving an adequate anatomical length, so that the patient’s expectation was fulfilled by not having to use prostheses to walk, and the patient satisfied with the result. The sensory flap based on the lateral femoral nerve is a limb salvage option, since length can be optimized and prosthesis use avoided.

REFERENCES

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