Background and objective.

The distally based anterolateral thigh flap is an interesting alternative for the reconstruction of skin defects of the knee.

The reason for this paper is the anatomical study of the descending artery of the lateral circumflex femoral and the existence or not of a distal anastomosis that allows us to perform the distally based flap.

Methods.

Different items were studied in 22 embalmed lower limbs: origin of the artery, distance from the outlet of the perforator of the descending artery to the skin, length and location of the descending artery, distal anastomosis if any, location of the pivot point taking as a reference point the supero-lateral corner of the patella, and the sum of the length of the perforator and the length of the descending artery, which gives us the length of the pedicle that we can obtain by dissecting the flap.

Results.

Related to the distal anastomosis, we described 2 models. Model 1: no anastomosis, with a ratio of 45%, and model 2: there is an anastomosis in 55%. In model 2 we have established 3 types of anastomosis: type 1, when the anastomosis is performed with the superior lateral geniculate artery, in 42%; type 2, anastomosis with the deep femoral artery, in 25%; and type 3, anastomosis with both, in 33%. The pivot point was found an average of 11 cm from the upper edge of the patella.The length of the pedicle had an average of 15 cm.

Conclusions.

Our results demonstrate that the distally based anterolateral flap is an adequate alternative for knee soft-tissue reconstruction. Due to the anatomical diversity, angiography or intraoperative revision of the distal anastomosis would be appropriate to perform this flap.

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