RECONSTRUCTION OF POSTTRAUMATIC DEFECTS OF THE FOOT BY FLOW-THROUGH ANTEROLATERAL OR ANTEROMEDIAL THIGH FLAPS WITH PRESERVATION OF POSTERIOR TIBIAL VESSELS

Massive posttraumatic defects of the foot in 4 patients and a tibial m alunion in another were repaired by flow-through anterior (anterolater al and anteromedial) thigh flaps. Posterior tibial vessels were used a s the recipient vessel just below the level of the medial malleolus. S oft-tissue defects in foot-injured patients were covered with flow-thr ough anterior thigh flaps interposing the descending branch of the lat eral circumflex femoral system between the transected posterior tibial vessels. In another patient, a combined anteromedial thigh flap and v ascularized iliac bone cross-leg ''chimeric'' flap were successfully t ransferred for the reconstruction of a malunion of a tibial fracture, which had been accompanied by severe vascular damage to the thigh, The utilization of derivative branches from the lateral circumflex femora l system facilitates revascularization of ischemic areas and simultane ous transplantation of multiple components, as well as preserves recip ient vessels. Owing to the stable blood supply, these flaps can be rea dily processed into both deepithelialized and thin flaps.