[Clinical application of the free anterolateral thigh myocutaneous flap with the tensor fascia lata for one-stage repair of soft tissues defects at the dorsum of hands (feets)].

Abstract

Objective: To explore the method and the therapeutic effect of the free anterolateral thigh myocutaneous flap with the tensor fascia lata for one-stage repair of soft tissues defects at the dorsum of hands (feets).

Method: Between Jan.2010 and Dec.014,8 patients with finger (toe) extensor tendon and dorsal foot defect were treated with anterolateral thigh myocutaneous flap. The defect area ranged from 6 cm ×5cm to 18 cm× 10cm.All of the soft tissues defects at the dorsum of hands (feets) combined with tendon colobomam. The free anterolateral thigh myocutaneous flap (ranged from 8 cm × 7cm to 20 cm × 12cm) were applied for one-stage repair of the soft tissues defects. The anterolateral thigh flap was used to repair defect and fascia lata was used to bridge two ends of digitorum longus tendon. The defects at donor sites were sutured directly or repaired with the split-thickness skin graft.2-3 months after the surgery, tenolysis for tendon was performed, and fascia lata was split into tendon-like shape and the finger (toe) functional exercises were done.

Results: All flaps survived completely after the first stage.Postoperative follow-up time was 6-12 months (average,8 months).Except 4 flaps with somewhat swelling, the other flaps had satisfactory appearance with soft texture. During the follow-up, part of the dorsiflexion function of hand recovered in 3 patients (5°-40°),and flexion function was normal;5 patients with soft tissues defects at the dorsum of foots could walk normally with no toe ptosis.

Conclusions: Application of the free anterolateral thigh myocutaneous flap with the tensor fascia lata can repair soft tissues defects at the dorsum of hands (feets) combined with tendon colobomam. It can repair soft tissues defect combined with finger (toe) extensor tendon defects. Excellent clinical results can be achieved with short treatment time and less damage to the donor site.