Clinical application of the extended reverse anterolateral leg flap

Objective To introduce the clinical application of the extended anterolateral leg flap,which is based on the superficial peroneal artery and lateral supramalleolar artery. Methods Through anatomic study on the blood supplies of the skin over the anterolateral portion of the leg.The combined superficial peroneal artery and lateral supramalleolar artery could extend the size of the traditional anterolateral leg flap.In addition,the point of pivot of the extended anterolateral leg flap could locate at the level of the lateral malleolus,which decreases the distance between the flap and recipient site.Clinically,we have used the extended anterolateral leg flaps in 60 patients to cover skin defect over the feet.The flap ranged from 16 cm×10 cm(pedicle length 8.0 cm)to 26 cm×7 cm(pedicle length 6.0 cm). Results In the series, the flap survived in 53 patients(88.3%)unevently,and partial necrosis occurred in 7 patients(11.7%).Conclusion Based on the combined superficial peroneal artery and lateral supramalleolar artery,the size of the traditional anterolateral leg flap could be inceased,which enlarges its value on the coverage of skin defects over the feet. Key words: Surgical flap; Leg;  Superficial peroneal artery; Lateral supramalleolar artery; Transplantation;  Microsurgical technique