Reconstruction of Postburn Contracture of the Forefoot Using the Anterolateral Thigh Flap

Abstract

BackgroundSevere forefoot deformities, particularly those involving the dorsum of the foot, cause inconvenience in daily activities of living including moderate pain on the dorsal aspect of the contracted foot while walking and difficulty in wearing nonsupportive shoes due to toe contractures. This paper presents clinical results of reconstruction of severe forefoot deformity using the anterolateral thigh (ALT) free flap.MethodsSevere forefoot deformities were reconstructed using ALT flaps in 7 patients (8 cases) between March 2012 and December 2015. The mean contracture duration was 28.6 years.ResultsAll the flaps survived completely. The size of the flaps ranged from 8 cm × 5 cm to 19 cm × 8 cm. The mean follow-up period was 10 months (range, 7 to 15 months). There was no specific complication at both the recipient and donor sites. There was one case where the toe contracture could not be completely treated after surgery. All of the patients were able to wear shoes and walk without pain. Also, the patients were highly satisfied with cosmetic results.ConclusionsThe ALT flap may be considered ideal for the treatment of severe forefoot deformity.

Perfusion decellularization of a human limb: A novel platform for composite tissue engineering and reconstructive surgery

“…Muscle and fasciocutaneous flaps, taken from autologous donor sites are currently the most utilized approach for VML and limb trauma repair [ 14 , 15 ]. In the case of skin grafting, a portion of autologous tissue can be surgically transposed to the injured site without its nourishing blood supply (free-grafting), significantly improving the healing process at the implanted site [ 16 , 17 ]. However, the volume and shape of the available donor tissue is limited.…”

The Free Anterolateral Thigh (ALT) Flap for Microsurgical Reconstruction of Traumatic Defects in Pediatric Foot

“…The most recent study is the Case Report published this July by Merter et al [11][12][13][14][15] referring to a 2 years old boy with a car-tyre friction/ avulsion injury to his left foot [16][17][18][19][20][21][22]. The defect was reconstructed successfully with an immediate ipsilateral ALT flap leaving the boy with no restrictions and a normal gait just 6 weeks post-operatively, eventually needing a revision with liposuction after 8 years.…”

Therapeutic failure and eventual solution for skin necrosis and exposed tendon of the dorsum of the foot: A case report

“…First, we used NPWT, which has high initial success with skin surgeries; however, granulation over the tendon was poor, resulting in the need for flap surgery after several weeks. Few useful wound‐covering methods exist for the dorsum site of the foot due to the limited amount of soft tissue . Previous research has suggested that treating with free flap (free abdominal muscle penetrating slit flap, anterolateral thigh free flap, peroneal free flap, scapular free flap) is useful for covering skin defects at the dorsum of the foot .…”

“…The aim of wound treatment is to cover the bone and joint, ensuring that the necrosis is fully covered. The tendon should be covered as fully as possible and treated with free tissue transfer . We performed an extensor digitorum brevis (EDB) flap for the skin necrosis in which the primary skin defect was covered, but the patient had a new skin necrosis at the donor site of the local flap .…”